1
|
Kim S, Yoo JH, Chueh HW. Tanner's target height formula underestimates final adult height in Korean adolescents and young adults: reassessment of target height based on the Korean National Health and Nutrition Examination Survey 2010-2019. BMJ Paediatr Open 2024; 8:e002653. [PMID: 39237268 PMCID: PMC11381647 DOI: 10.1136/bmjpo-2024-002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 08/16/2024] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE Estimating children's target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner's formula to predict children's final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner's formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children. DESIGN/SETTING Data were derived from the Korean National Health and Nutrition Examination Survey 2010-2019. PATIENTS A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner's formula could not be calculated because of missing parental height data. MAIN OUTCOME MEASURES Tanner-based TH was compared with the FAH. RESULTS The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons' and daughters' heights, respectively. CONCLUSIONS Tanner's formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.
Collapse
Affiliation(s)
- Sejin Kim
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Busan, Korea (the Republic of)
| | - Jae Ho Yoo
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Busan, Korea (the Republic of)
| | - Hee Won Chueh
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Busan, Korea (the Republic of)
| |
Collapse
|
2
|
Moletta FB, Lobe MCS, França SN, de Lacerda L, Pereira RM. Pubertal, Auxological, and Adult Height Outcomes in Children Treated for Adrenocortical Tumors: Half a Century Experience. Horm Res Paediatr 2024:1-10. [PMID: 39173606 DOI: 10.1159/000540706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION Most children with adrenocortical tumors (ACTs) present with accelerated growth and skeletal maturation at diagnosis, which potentially compromises their adult heights (AHs). Knowledge about growth and pubertal patterns after ACT resection is scarce. This study presents the pubertal and auxological development of patients treated for ACT and followed up at a single pediatric endocrinology service in Brazil. METHODS Retrospective cohort study including 63 patients (47 girls) followed up between 1966 and 2021. Pubertal and auxological data from ACT diagnosis to AH were analyzed. RESULTS At diagnosis, the patients had median values of bone age (BA) more advanced than chronological age (CA), height standard deviation score greater than target height (TH-SDS), and predicted adult height (PAH-SDS) lower than TH-SDS. The difference between BA and CA decreased gradually during follow-up and the PAH-SDS moved closer to the TH-SDS 7 years after tumor resection. Puberty started at a median CA of 9.3 (8.3-11.3) years in girls and 9.9 (9.2-13.6) years in boys. Nine patients (6 girls) developed central precocious puberty (CPP), which was influenced by a CA >4 years at diagnosis. The difference between AH-SDS and TH-SDS was not significant (p = 0.3). The factors independently associated with AH below TH were CA >4 years at diagnosis, time between clinical manifestation and diagnosis >1 year, and development of CPP. CONCLUSION Most patients treated for ACT during childhood attained AH within the TH despite presenting with advanced skeletal maturation at diagnosis. Development of CPP was not infrequent.
Collapse
Affiliation(s)
- Fernanda Bora Moletta
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | | | - Suzana Nesi França
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | - Luiz de Lacerda
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | - Rosana Marques Pereira
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| |
Collapse
|
3
|
Xavier CB, Dassie-Leite AP, Pereira RM, Nesi-França S, De Lacerda L. Vocal Characteristics of Children With Short Stature Before and After Growth Hormone Treatment. J Voice 2024; 38:968.e9-968.e17. [PMID: 35090764 DOI: 10.1016/j.jvoice.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the vocal characteristics of children with short stature before and 12 months after growth hormone treatment. MATERIAL AND METHODS This analytical, observational cohort study included 23 children (age 5-11 years) diagnosed with short stature. Children in the short stature group (SSG) were matched (1:1) for age and sex with children with normal growth (normal stature group; NSG). Participants in the SSG underwent assessments before and 12 months after growth hormone treatment, while those in the NSG underwent the same assessments at baseline and 12 months. The assessments included evaluation of (A) vocal characteristics (history, vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis), (B) anthropometry, (C) bone age, and (D) measurement of insulin-like growth factor-1 (IGF-1) levels. RESULTS Children in the SSG had more vocal complaints (P = 0.026) than those in the NSG. The groups were similar in terms of vocal self-assessment and auditory-perceptual evaluation (P = nonsignificant). Results of acoustic analysis were also similar for fundamental frequency (F 0) and perturbation measures (P for both = nonsignificant). F 0 and speech frequency decreased significantly at 12 months in both groups. F1 values were higher at 12 months in the NSG, while F2 values were significantly higher in the baseline evaluation in boys in the SSG. Children in the SSG compared with those in the NSG presented a greater increase in height measurements at 12 months, although the anthropometric means were lower in both evaluations (P < 0.001). CONCLUSION Vocal characteristics in children with short stature before and after treatment with growth hormone are comparable to those in children with normal growth.
Collapse
Affiliation(s)
- Congeta Bruniera Xavier
- Postgraduate Program of Childhood and Adolescence Health, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Ana Paula Dassie-Leite
- Department of Speech-Language Pathology, Universidade Estadual do Centro-Oeste, Irati, Paraná, Brazil
| | - Rosana Marques Pereira
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Suzana Nesi-França
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Luiz De Lacerda
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| |
Collapse
|
4
|
Therrell BL, Padilla CD, Borrajo GJC, Khneisser I, Schielen PCJI, Knight-Madden J, Malherbe HL, Kase M. Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020-2023). Int J Neonatal Screen 2024; 10:38. [PMID: 38920845 PMCID: PMC11203842 DOI: 10.3390/ijns10020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 06/27/2024] Open
Abstract
Newborn bloodspot screening (NBS) began in the early 1960s based on the work of Dr. Robert "Bob" Guthrie in Buffalo, NY, USA. His development of a screening test for phenylketonuria on blood absorbed onto a special filter paper and transported to a remote testing laboratory began it all. Expansion of NBS to large numbers of asymptomatic congenital conditions flourishes in many settings while it has not yet been realized in others. The need for NBS as an efficient and effective public health prevention strategy that contributes to lowered morbidity and mortality wherever it is sustained is well known in the medical field but not necessarily by political policy makers. Acknowledging the value of national NBS reports published in 2007, the authors collaborated to create a worldwide NBS update in 2015. In a continuing attempt to review the progress of NBS globally, and to move towards a more harmonized and equitable screening system, we have updated our 2015 report with information available at the beginning of 2024. Reports on sub-Saharan Africa and the Caribbean, missing in 2015, have been included. Tables popular in the previous report have been updated with an eye towards harmonized comparisons. To emphasize areas needing attention globally, we have used regional tables containing similar listings of conditions screened, numbers of screening laboratories, and time at which specimen collection is recommended. Discussions are limited to bloodspot screening.
Collapse
Affiliation(s)
- Bradford L. Therrell
- Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
- National Newborn Screening and Global Resource Center, Austin, TX 78759, USA
| | - Carmencita D. Padilla
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines;
| | - Gustavo J. C. Borrajo
- Detección de Errores Congénitos—Fundación Bioquímica Argentina, La Plata 1908, Argentina;
| | - Issam Khneisser
- Jacques LOISELET Genetic and Genomic Medical Center, Faculty of Medicine, Saint Joseph University, Beirut 1104 2020, Lebanon;
| | - Peter C. J. I. Schielen
- Office of the International Society for Neonatal Screening, Reigerskamp 273, 3607 HP Maarssen, The Netherlands;
| | - Jennifer Knight-Madden
- Caribbean Institute for Health Research—Sickle Cell Unit, The University of the West Indies, Mona, Kingston 7, Jamaica;
| | - Helen L. Malherbe
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa;
- Rare Diseases South Africa NPC, The Station Office, Bryanston, Sandton 2021, South Africa
| | - Marika Kase
- Strategic Initiatives Reproductive Health, Revvity, PL10, 10101 Turku, Finland;
| |
Collapse
|
5
|
Rojas-Ramos JCR, Pelaez JM, Ono SE, Ramos CS, de Carvalho Neto A, de Lacerda L, Nesi-França S. Cerebral Cortical Thickness Morphometry and Neurocognitive Correlations in Adolescents With Congenital Hypothyroidism. J Clin Endocrinol Metab 2023; 108:e1496-e1505. [PMID: 37403211 DOI: 10.1210/clinem/dgad391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
CONTEXT Subtle cognitive impairments have been described in children with congenital hypothyroidism (CH) detected by neonatal screening (NS), even with early and adequate treatment. Patients with CH may present with brain cortical thickness (CT) abnormalities, which may be associated with neurocognitive impairments. OBJECTIVE This work aimed to evaluate the CT in adolescents with CH detected by the NS Program (Paraná, Brazil), and to correlate possible abnormalities with cognitive level and variables of neurocognitive prognosis. METHODS A review was conducted of medical records followed by psychometric evaluation of adolescents with CH. Brain magnetic resonance imaging with analysis of 33 brain areas of each hemisphere was performed in 41 patients (29 girls) and in a control group of 20 healthy adolescents. CT values were correlated with Full-scale Intelligence Quotient (FSIQ) scores, age at start of treatment, pretreatment thyroxine levels, and maternal schooling. RESULTS No significant difference in CT between patients and controls were found. However, there was a trend toward thinning in the right lateral orbitofrontal cortex among patients and in the right postcentral gyrus cortex among controls. CT correlated significantly with FSIQ scores and with age at start of treatment in 1 area, and with hypothyroidism severity in 5 brain areas. Maternal schooling level did not correlate with CT but was significantly correlated with FSIQ. Cognitive level was within average in 44.7% of patients (13.2% had intellectual deficiency). CONCLUSION There was a trend toward morphometric alterations in the cerebral cortex of adolescents with CH compared with healthy controls. The correlations between CT and variables of neurocognitive prognosis emphasize the influence of hypothyroidism on cortical development. Socioeconomic status exerts a limiting factor on cognitive outcome.
Collapse
Affiliation(s)
- Juliana Cristina Romero Rojas-Ramos
- Fundação Ecumênica de Proteção ao Excepcional (FEPE), Curitiba, Paraná 80210-170, Brazil
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (UEP-CHC-UFPR), Curitiba, Paraná 80060-240, Brazil
| | - Julita Maria Pelaez
- Fundação Ecumênica de Proteção ao Excepcional (FEPE), Curitiba, Paraná 80210-170, Brazil
| | - Sergio Eiji Ono
- Clínica DAPI-Diagnóstico Avançado Por Imagem, Curitiba, Paraná 80430-210, Brazil
| | - Cássio Slompo Ramos
- Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil
| | | | - Luiz de Lacerda
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (UEP-CHC-UFPR), Curitiba, Paraná 80060-240, Brazil
| | - Suzana Nesi-França
- Serviço de Endocrinologia Pediátrica Professor Romolo Sandrini-Complexo Hospital de Clínicas da Universidade Federal do Paraná (UEP-CHC-UFPR), Curitiba, Paraná 80060-240, Brazil
| |
Collapse
|
6
|
Pelaez JM, Rojas-Ramos JCR, Domingos MT, de Lima MR, Kraemer GDC, Cardoso-Demartini ADA, Pereira RM, de Lacerda L, Nesi-França S. Cognitive outcome of 458 children over 25 years of neonatal screening for congenital hypothyroidism. J Pediatr (Rio J) 2023; 99:478-484. [PMID: 37088106 PMCID: PMC10492150 DOI: 10.1016/j.jped.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVES To describe the neurocognitive profile of 458 children with congenital hypothyroidism detected by neonatal screening, followed under the same treatment protocol over 25 years. To correlate estimated full-scale IQ (FSIQ) scores with age at the start of treatment, disease severity, and maternal education. METHODS Observational, analytical, retrospective, and longitudinal cohort study, that evaluated children detected between 1991 and 2014, who underwent at least one psychometric assessment (WPPSI- R and/or WISC-III). Estimated FSIQ scores are described and correlated with prognosis determinants. RESULTS Median T4 at diagnosis was 2.8 μg/dL (0.0-16.5), the median age at the start of treatment was 18.5 days (3-309). Maternal education (n = 445): 2.7% of illiteracy, 59.8% with basic education. Estimated FSIQ scores were 88.0 (±11.8) in WPPSI-R (age 5.6 ± 0.5 years) and 84.1 (±13.0) in WISC-III (age 9.1 ± 1.4 years). The intellectual deficit was identified in 11.6%. Correlation between age at the start of treatment and estimated FSIQ was found only in the WPPSI-R test (p = 0.02). Initial T4 and maternal education significantly correlated with estimated FSIQ scores in both tests, with the latter being the most important determining factor. CONCLUSIONS In this large cohort of mainly low socioeconomic status children, most children achieved normal cognitive levels; however, a significant percentage presented with below-average estimated FSIQ scores and intellectual deficits. Maternal education was the main determining factor in cognitive level followed by hypothyroidism severity.
Collapse
Affiliation(s)
| | - Juliana Cristina Romero Rojas-Ramos
- Fundação Ecumênica de Proteção ao Excepcional (FEPE), Curitiba, PR, Brazil; Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil
| | | | | | - Gabriela de Carvalho Kraemer
- Fundação Ecumênica de Proteção ao Excepcional (FEPE), Curitiba, PR, Brazil; Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil
| | - Adriane de Andre Cardoso-Demartini
- Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil
| | - Rosana Marques Pereira
- Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil
| | - Luiz de Lacerda
- Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil
| | - Suzana Nesi-França
- Unidade de Endocrinologia Pediátrica (UEP), Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC - UFPR), Curitiba, PR, Brazil.
| |
Collapse
|