Antonio Carrascosa1, Diego Yeste2, Antonio Moreno-Galdó3, Miquel Gussinyé4, Ángel Ferrández5, María Clemente2, Mónica Fernández-Cancio2. 1. Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España; CIBER de Enfermedades Raras (CIBERER) ISCIII, España. Electronic address: ancarrascosa@vhebron.net. 2. Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España; CIBER de Enfermedades Raras (CIBERER) ISCIII, España. 3. CIBER de Enfermedades Raras (CIBERER) ISCIII, España; Sección de Neumología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España. 4. Servicio de Endocrinología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España. 5. Centro Andrea Prader, Zaragoza, España.
Abstract
INTRODUCTION: Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period (girls: 8-13 years, boys: 10-15 years). The need for more than one pubertal reference pattern has been proposed. We aimed to obtain five 1-year-age-interval pubertal patterns. SUBJECTS AND METHODS: Longitudinal (6 years of age-adult height) growth study of 1,453 healthy children to evaluate height-for-age, growth velocity-for-age and weight-for-age values. According to age at pubertal growth spurt onset girls were considered: very-early matures (8-9 years, n=119), early matures (9-10 years, n=157), intermediate matures (10-11 years, n=238), late matures (11-12 years, n=127) and very-late matures (12-13 years, n=102), and boys: very-early matures (10-11 years, n=110), early matures (11-12 years, n=139), intermediate matures (12-13 years, n=225), late matures (13-14 years, n=133) and very-late matures (14-15 years, n=103). Age at menarche and growth up to adult height were recorded. RESULTS: In both sexes, statistically-significant (P<.0001) and clinically-pertinent differences in pubertal growth pattern (mean height-for-age, mean growth velocity-for-age and mean pubertal height gain, values) were found among the five pubertal maturity groups and between each group and the whole population, despite similar adult height values. The same occurred for age at menarche and growth from menarche to adult height (P<.05). CONCLUSIONS: In both sexes, pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development. The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used.
INTRODUCTION: Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period (girls: 8-13 years, boys: 10-15 years). The need for more than one pubertal reference pattern has been proposed. We aimed to obtain five 1-year-age-interval pubertal patterns. SUBJECTS AND METHODS: Longitudinal (6 years of age-adult height) growth study of 1,453 healthy children to evaluate height-for-age, growth velocity-for-age and weight-for-age values. According to age at pubertal growth spurt onset girls were considered: very-early matures (8-9 years, n=119), early matures (9-10 years, n=157), intermediate matures (10-11 years, n=238), late matures (11-12 years, n=127) and very-late matures (12-13 years, n=102), and boys: very-early matures (10-11 years, n=110), early matures (11-12 years, n=139), intermediate matures (12-13 years, n=225), late matures (13-14 years, n=133) and very-late matures (14-15 years, n=103). Age at menarche and growth up to adult height were recorded. RESULTS: In both sexes, statistically-significant (P<.0001) and clinically-pertinent differences in pubertal growth pattern (mean height-for-age, mean growth velocity-for-age and mean pubertal height gain, values) were found among the five pubertal maturity groups and between each group and the whole population, despite similar adult height values. The same occurred for age at menarche and growth from menarche to adult height (P<.05). CONCLUSIONS: In both sexes, pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development. The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used.
Keywords:
Crecimiento puberal; Inicio del brote de crecimiento puberal; Pubertal growth; Pubertal growth spurt onset; Pubertal growth velocity-for-age values; Pubertal height-for age values; Pubertal weight-for-age values; Valores de peso para la edad; Valores de talla para la edad; Valores de velocidad de crecimiento para la edad