Kyriakie Sarafoglou1, O Yaw Addo2, Lucie Turcotte3, Noelle Otten3, Andrea Wickremasinghe4, Siobhan Pittock5, Jennifer Kyllo6, Aida N Lteif5, John H Himes2, Bradley S Miller3. 1. Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN. Electronic address: saraf010@umn.edu. 2. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN. 3. Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN. 4. Department of Pediatrics, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA. 5. Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN. 6. Division of Diabetes and Endocrinology, Children's Hospitals of Minnesota, Minneapolis, MN.
Abstract
OBJECTIVE: To estimate the impact of the average daily dose of hydrocortisone (HC) on the amount of growth attained in children with congenital adrenal hyperplasia (CAH). The effect of glucocorticoid therapy on adult height (AH) in children with CAH has yet to be elucidated. STUDY DESIGN: Triple-logistic models estimating components of growth and maturation were fitted to longitudinal records of 104 patients with classic CAH from 3 pediatric medical centers in Minnesota between 1955 and 2012. A total of 3664 clinical encounters were examined. Random-effects longitudinal models with time-related covariates were used to estimate the effect of HC therapy on linear growth. RESULTS: The predicted AH z-score (-0.7) was similar between the sexes and among CAH subtypes. The mean growth period HC dose was 18.9 ± 5.6 mg/m(2)/day. In the final regression model, HC dose was negatively associated with predicted AH, with each mg/m(2)/day increase in average growth period HC dose predicting a 0.37-cm decrease in AH (P < .004). CONCLUSION: This study has quantified the fractional reduction in predicted final AH with an incremental increase in HC dose. These findings have important clinical implications in the decision making balance between HC replacement dose and adrenal androgen suppression in children with CAH.
OBJECTIVE: To estimate the impact of the average daily dose of hydrocortisone (HC) on the amount of growth attained in children with congenital adrenal hyperplasia (CAH). The effect of glucocorticoid therapy on adult height (AH) in children with CAH has yet to be elucidated. STUDY DESIGN: Triple-logistic models estimating components of growth and maturation were fitted to longitudinal records of 104 patients with classic CAH from 3 pediatric medical centers in Minnesota between 1955 and 2012. A total of 3664 clinical encounters were examined. Random-effects longitudinal models with time-related covariates were used to estimate the effect of HC therapy on linear growth. RESULTS: The predicted AH z-score (-0.7) was similar between the sexes and among CAH subtypes. The mean growth period HC dose was 18.9 ± 5.6 mg/m(2)/day. In the final regression model, HC dose was negatively associated with predicted AH, with each mg/m(2)/day increase in average growth period HC dose predicting a 0.37-cm decrease in AH (P < .004). CONCLUSION: This study has quantified the fractional reduction in predicted final AH with an incremental increase in HC dose. These findings have important clinical implications in the decision making balance between HC replacement dose and adrenal androgen suppression in children with CAH.
Authors: Kyriakie Sarafoglou; Gregory P Forlenza; O Yaw Addo; Jennifer Kyllo; Aida Lteif; P C Hindmarsh; Anna Petryk; Maria Teresa Gonzalez-Bolanos; Bradley S Miller; William Thomas Journal: Clin Endocrinol (Oxf) Date: 2017-03-28 Impact factor: 3.478
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Authors: Richard J Auchus; Kyriakie Sarafoglou; Patricia Y Fechner; Maria G Vogiatzi; Erik A Imel; Shanlee M Davis; Nagdeep Giri; Julia Sturgeon; Eiry Roberts; Jean L Chan; Robert H Farber Journal: J Clin Endocrinol Metab Date: 2022-02-17 Impact factor: 5.958
Authors: Uta Neumann; Katarina Braune; Martin J Whitaker; Susanna Wiegand; Heiko Krude; John Porter; Dena Digweed; Bernard Voet; Richard J M Ross; Oliver Blankenstein Journal: J Clin Endocrinol Metab Date: 2021-03-08 Impact factor: 5.958
Authors: Mahmoud Al-Kofahi; Mariam A Ahmed; Mutaz M Jaber; Thang N Tran; Brian A Willis; Cheryl L Zimmerman; Maria T Gonzalez-Bolanos; Richard C Brundage; Kyriakie Sarafoglou Journal: Br J Clin Pharmacol Date: 2020-07-26 Impact factor: 3.716