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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Cohen, Pinhas / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Roth, Christian / Toppari, Jorma

Editorial Board Member: Battelino, Tadej / Buyukgebiz, Atilla / Cassorla, Fernando / Chrousos, George P. / Cutfield, Wayne / Fideleff, Hugo L. / Hershkovitz, Eli / Hiort, Olaf / LaFranchi, Stephen H. / Lanes M. D., Roberto / Mohn, Angelika / Root, Allen W. / Rosenfeld, Ron G. / Werther, George / Zadik, Zvi

12 Issues per year


IMPACT FACTOR 2016: 1.233

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2191-0251
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Volume 29, Issue 12 (Dec 2016)

Issues

Growth curves for congenital adrenal hyperplasia from a national retrospective cohort

Patricia Bretones
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Other articles by this author:
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/ Benjamin Riche
  • Université Claude Bernard Lyon 1, Lyon, France
  • Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
  • CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
  • Other articles by this author:
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/ Emmanuel Pichot
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Other articles by this author:
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/ Michel David
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Université Claude Bernard Lyon 1, Lyon, France
  • Other articles by this author:
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/ Pascal Roy
  • Université Claude Bernard Lyon 1, Lyon, France
  • Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
  • CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
  • Other articles by this author:
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/ Véronique Tardy
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Université Claude Bernard Lyon 1, Lyon, France
  • Endocrinologie moléculaire et maladies rares, Hospices Civils de Lyon, Bron, France
  • Other articles by this author:
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/ Behrouz Kassai
  • Université Claude Bernard Lyon 1, Lyon, France
  • CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
  • INSERM, CIC1407, Bron, France
  • Service de Pharmacologie Clinique, Hospices Civils de Lyon, Bron, France
  • Other articles by this author:
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/ Ségolène Gaillard / Delphine Bernoux
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • INSERM, CIC1407, Bron, France
  • Other articles by this author:
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/ Yves Morel
  • Université Claude Bernard Lyon 1, Lyon, France
  • Endocrinologie moléculaire et maladies rares, Hospices Civils de Lyon, Bron, France
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/ Pierre Chatelain
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Université Claude Bernard Lyon 1, Lyon, France
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/ Marc Nicolino
  • Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Bron, France
  • Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France
  • Université Claude Bernard Lyon 1, Lyon, France
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/ Catherine Cornu
  • Corresponding author
  • Université Claude Bernard Lyon 1, Lyon, France
  • INSERM, CIC1407, Bron, France
  • Service de Pharmacologie Clinique, Hospices Civils de Lyon, Bron, France
  • Hospices Civils de Lyon – Centre d’Investigation Clinique INSERM CIC1407/UMR5558 Hôpital Louis Pradel 28, Avenue du Doyen Lépine Bron 69677, France, Phone: +33 (0)4 72 35 72 31
  • Email
  • Other articles by this author:
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/ for the French Collaborative CAH Growth Study Group
Published Online: 2016-11-16 | DOI: https://doi.org/10.1515/jpem-2016-0156

Abstract

Background:

In congenital adrenal hyperplasia (CAH), adjusting hydrocortisone dose during childhood avoids reduced adult height. However, there are currently no CAH-specific charts to monitor growth during treatment. Our objective was to elaborate growth reference charts and bone maturation data for CAH patients.

Methods:

We conducted a retrospective observational cohort study, in 34 French CAH centers. Patients were 496 children born 1970–1991 with genetically proven 21-hydroxylase deficiency. Their growth and bone maturation data were collected until age 18 together with adult height, puberty onset, parental height, and treatment. The mean (SD) heights were modeled from birth to adulthood. The median±1 SD and ±2 SDs model-generated curves were compared with the French references. A linear model for bone maturation and a logistic regression model for the probability of short adult height were built.

Results:

Growth charts were built by sex for salt wasting (SW) and simple virilizing (SV) children treated before 1 year of age. In girls and boys, growth was close to that of the general French population up to puberty onset. There was almost no pubertal spurt and the mean adult height was shorter than that of the general population in girls (−1.2 SD, 156.7 cm) and boys (−1.0 SD, 168.8 cm). Advanced bone age at 8 years had a strong impact on the risk of short adult height (OR: 4.5 per year advance).

Conclusions:

The 8-year bone age is a strong predictor of adult height. It will help monitoring the growth of CAH-affected children.

Keywords: adult height; bone maturation; congenital adrenal hyperplasia; growth

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About the article

Deceased


Received: 2016-04-23

Accepted: 2016-09-26

Published Online: 2016-11-16

Published in Print: 2016-12-01


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Contributors: Clinical Investigation Center: E. Brocard, S. Gaillard, C. Cornu, B. Kassaï, A. Delahaye, C. Desprez, M. Pelosse, C. Eloy. Biostatistics: L. Remontet, B. Riche, P. Roy. The Collaborative CAH Growth Study Group: Régis Coutant, Anne-Marie Bertrand, Chantal Metz, Guy-André Loeuille, Philippe Garnier, Anne Lienhardt-Roussie, Gilbert Simonin, Rachel Reynaud, Charles Sultan, Claire Jeandel, Bruno Leheup, Kathy Wagner, Paul Czernichow, Juliane Leger-Metoudi, Odile Richard, Sylvie Soskin, Maité Tauber, Catherine Pienkowski, Michel Polak, Graziella Pinto, Claire Nihoul-Fekete, Yves Le Bouc, Sylvie Cabrol, Marie-Charles Raux-Demay, Hélène Carla, Marc De Kerdanet, Candace Ben Signore, François Despert, Eric Mallet, Claudine Lecointre, Véronique Sulmont, Pierre-François Souchon, Hubert Ythier, Paola Adiceam, Pierre-François Bougneres, Claire Bouvattier, Sabine Baron, Pascal Barat, Michel Colle, Elisabeth Baechler, Raja Brauner, Jacques Weill, Maryse Gatigny, Marc Jullien.

Research funding: The study was funded by the Scientific Council of “Association Surrénales” and by Hospices Civils de Lyon (“Jeune chercheur” and interrégional PHRC calls).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Journal of Pediatric Endocrinology and Metabolism, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2016-0156.

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