title: The relation of peripubertal and pubertal growth to final adult height in children with classic congenital adrenal hyperplasia.
abstract: OBJECTIVE
  To determine the relationships between peripubertal and pubertal timing and growth, along with glucocorticoid exposure, to the reduced final adult height seen in patients with congenital adrenal hyperplasia (CAH).
  
  
  METHODS
  Chart review of 104 children with classic CAH (41 males: 28 salt-wasting, 13 simple-virilizing; 63 females: 38 salt-wasting, 25 simple-virilizing) were selected from a cohort from 3 medical institutions in Minnesota. Triple logistic modeling of longitudinal data was performed to determine patterns of peripubertal and pubertal growth.
  
  
  RESULTS
  Hydrocortisone dose was similar between subtypes and during all growth periods. Simple-virilizing boys (P < .01) and girls (P < .01) were diagnosed later than their salt-wasting counterparts. Height at take-off SDS was reduced for patients with salt-wasting (boys: P < .01; girls: P < .01), and bone age at take-off SDS was more advanced for patients with simple-virilizing (boys: P < .01; girls: P = .05). Bone age at pubertal onset SDS was advanced for all patients, but more so for boys and girls with simple-virilizing. Although all patients had reduced final adult height SDS, this was more pronounced in patients with salt-wasting.
  
  
  CONCLUSIONS
  Reduced final adult height SDS in patients with salt-wasting vs simple-virilizing may be attributable in part to a later age of diagnosis and resultant less prolonged exposure to hydrocortisone. This finding suggests that duration of hydrocortisone treatment in the peripubertal period, independent of the hydrocortisone dose, may affect final adult height in patients with CAH.
authors.affiliation: Department of Pediatrics, University of Minnesota Children's Hospital, Minneapolis, MN.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Bomberg
authors.affiliation: Global Health, Rollins School of Public Health of Emory University, Atlanta, GA.
authors.forename: O Yaw
authors.initials: OY
authors.lastname: Addo
authors.affiliation: Pediatrics, Children's Hospitals of Minnesota, Minneapolis, MN.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kyllo
authors.affiliation: Department of Pediatrics, University of Minnesota Children's Hospital, Minneapolis, MN.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Gonzalez-Bolanos
authors.affiliation: The Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Aida M
authors.initials: AM
authors.lastname: Ltief
authors.affiliation: The Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Pittock
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.affiliation: Department of Pediatrics, University of Minnesota Children's Hospital, Minneapolis, MN.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Miller
authors.affiliation: Department of Pediatrics, University of Minnesota Children's Hospital, Minneapolis, MN. Electronic address: saraf010@umn.edu.
authors.forename: Kyriakie
authors.initials: K
authors.lastname: Sarafoglou
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D000375:Aging / Q000502:physiology*; D001827:Body Height / Q000187:drug effects / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012741:Sexual Maturation / Q000187:drug effects / Q000502:physiology*
chemical_list: D005938:Glucocorticoids