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Adult height prediction model useful in children born small for gestational age

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In short children born small for gestational age treated with growth hormone, the prediction model for adult height provides valuable knowledge of probable long-term growth.

Researchers from The Netherlands performed two GH studies in 150 short children born small for gestational age with height standard deviation scores less than –2. Children were aged three years or older with no signs of catch-up growth and had been treated with GH for at least one year before the onset of puberty.

In one study, the researchers randomly assigned children to 0.033 mg/kg or 0.067 mg/kg GH per day. In the second, children were assigned to 0.033 mg/kg GH per day. Seventy-one patients achieved adult height.

Age at the start of treatment and female gender were negatively related to height SD scores at the onset of puberty. Height SD scores at baseline, target SD scores and GH dose were positively related to height SD scores at puberty.

For adult height SD scores, those determinants positively related were: height SD scores, chronological age, bone age at baseline, target height SD scores and GH dose. Serum IGF binding protein-3 SD scores at baseline was negatively related. Findings indicated a smaller GH dose effect for higher levels of IGFBP-3.

According to the researchers, the final prediction model explained 57% of the difference in height SD scores at the onset of puberty and 41% of adult height SD scores. Because GH dose was a determinant, the prediction model may help to determine optimal GH dose. – by Stacey L. Adams

J Clin Endocrinol Metab. 2008;93:477-483.

This prediction model expands the usefulness of this approach and also gives the physician predictions about final height, while other models only provide predictions about the first year. All of these prediction models are flawed to a degree because they don’t explain the whole thing; in a way, these prediction models are like predicting how the stock market will do. I think this prediction model is better than the others, but the overall problem with them is that they are good for groups but often less accurate for individual patients.

–Paul Saenger, MD, MACE

Endocrine Today Editorial Board member