#BONE AGE LESS THAN CHRONOLOGICAL AGE LICENSE#

However, data on the BA progression rate of prepubertal patients with GHD over long-term GH treatment are insufficient. Nonetheless, the BA progression rate of those who receive GH treatment varies and can be either within the normal range or accelerated, and the results may be affected by age, sex, underlying disease, GH dose, duration of GH treatment, or pubertal status.Īs the height at onset of puberty and final height are closely associated, maximizing the duration of prepubertal GH treatment may be beneficial. Therefore, the BA progression rate during GH treatment has an important impact on adult height prediction. When predicting adult height, the Bayley and Pinneau method use specific tables for delayed, average, and advanced BA which are determined by the Greulich and Pyle hand standards. The goal of GH treatment is to increase final adult height. BA changes can be erratic over time, even in normal healthy boys. Usually, BA progression rates within 1 year of CA are considered normal, but some studies have found that various rates of skeletal maturation can be associated with underlying diseases, pubertal status, and obesity. After GH treatment, increased serum IGF-1 or GH levels stimulate growth plate development and result in BA progression. In children with GH deficiency (GHD), bone age (BA) is significantly delayed compared to chronological age (CA). GH and IGF-1 are traditionally considered potent stimulators of bone growth. Many signals are involved in growth plate maturation, including growth hormone (GH), insulin-like growth factor-1 (IGF-1), glucocorticoids, thyroid hormone, estrogen, androgen, vitamin D, leptin, paracrine factors, extracellular matrix, and intracellular mechanisms. However, because the BA progression rate was considered to be clinically acceptable, GH treatment may increase the predicted adult height during this period. Prepubertal subjects with iGHD and ISS showed height improvement and mild BA acceleration over the first 3 years of GH treatment. The baseline BA-CA, IGF-1 SDS, and GH dose did not influence BA progression. The only significant factor associated with the BA progression was the BA-CA at 1 year of GH treatment (OR = 2.732, P =. 648) the change in BA over the 3 years was 3.88 ± 1.36 years. In the ISS subjects, the height z-score was −1.06 ± 0.59 ( P <. 001) in the iGHD subjects the change in BA over the 3 years was 3.68 ± 1.27 years. 001), and IGF-1 standard deviation score (SDS) was 0.43 ± 1.21 ( P <. 001 compared to baseline), BA-CA was −1.21 ± 1.18 years ( P <. This study included 92 (78 iGHD and 14 ISS) subjects.Īfter 3 years of GH treatment, the height z-score was −1.09 ± 0.71 ( P <.

Differences between BA and chronological age (CA), BA-CA, were calculated at each measurement. Height, weight, BA, insulin-like growth factor-1 (IGF-1) level, and GH dose were recorded every 6 months. To investigate the progression rate of bone age (BA) and associated factors during the first 3 years of growth hormone (GH) treatment in children with idiopathic GH deficiency (iGHD) and idiopathic short stature (ISS).ĭata for prepubertal children with iGHD and ISS who were treated with recombinant human GH were obtained from the LG Growth Study Database and analyzed. The work cannot be used commercially without permission from the journal.

#BONE AGE LESS THAN CHRONOLOGICAL AGE LICENSE#

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. EYK is a full-time employee of LG Chem, Ltd. ∗Correspondence: Il Tae Hwang, Department of Pediatrics, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea (e-mail: ).Ībbreviations: BA = bone age, BMI = body mass index, CA = chronological age, GH = growth hormone, GHD = GH deficiency, IGF-1 = insulin-like growth factor-1, IGFBP-3 = IGF-binding protein-3, iGHD = idiopathic GHD, ISS = idiopathic short stature, LGS = LG Growth Study, MMRM = mixed-effects model repeated measures, SD = standard deviation, SDS = standard deviation score.ĭisclosure of potential conflicts of interest: ITH is a member of the Observational Study Monitoring Board of the LG Growth Study. ADepartment of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Gangwon-doīLife Science R&D, LG Chem, Ltd., Gangseo-gu, Seoul, Republic of Korea.

Bone age less than chronological age