Jia Zhu1,2, Lisa K Volkening1, Lori M Laffel1,2. 1. Joslin Diabetes Center, One Joslin Place, Boston, Massachusetts. 2. Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
Abstract
Context: Assessment of pubertal change is important for the management of chronic pediatric diseases, such as type 1 diabetes. Physical and/or laboratory assessments of pubertal status are often unavailable, impractical, or costly. Objective: To develop and validate a practical and objective method to assess pubertal status using longitudinal linear growth in youths with type 1 diabetes. Design, Participants, and Outcome Measurements: Participants (n = 123) were part of a 2-year study assessing continuous glucose monitoring in youths with type 1 diabetes at a tertiary diabetes center. Pubertal status at visits was assigned by a tiered approach using clinical Tanner staging or indicators of pubertal maturation from the electronic medical record when available. For other visits, independent evaluations of height velocities and growth chart trajectories provided data for pubertal status assignments. Sensitivity analysis confirmed the validity of the pubertal status assignments. Results: The sample (50% female, 95% white) had a mean ± SD age of 12.7 ± 2.7 years, diabetes duration of 6.0 ± 3.6 years, and hemoglobin A1c of 7.9 ± 0.8%. Of 985 study visits, 50% received a pubertal status assignment based on clinical Tanner staging, 29% on additional medical record review, and 22% on an evaluation of height velocity and growth chart trajectory. For the sensitivity analysis, pubertal status assignments based on height velocity and growth chart trajectory matched clinical Tanner staging in 87% of visits. Conclusions: Our practical and objective method to assess pubertal status based on height velocity and growth chart trajectory highlights growth as a reliable and objective bioassay for pubertal onset, status, and progression.
Context: Assessment of pubertal change is important for the management of chronic pediatric diseases, such as type 1 diabetes. Physical and/or laboratory assessments of pubertal status are often unavailable, impractical, or costly. Objective: To develop and validate a practical and objective method to assess pubertal status using longitudinal linear growth in youths with type 1 diabetes. Design, Participants, and Outcome Measurements: Participants (n = 123) were part of a 2-year study assessing continuous glucose monitoring in youths with type 1 diabetes at a tertiary diabetes center. Pubertal status at visits was assigned by a tiered approach using clinical Tanner staging or indicators of pubertal maturation from the electronic medical record when available. For other visits, independent evaluations of height velocities and growth chart trajectories provided data for pubertal status assignments. Sensitivity analysis confirmed the validity of the pubertal status assignments. Results: The sample (50% female, 95% white) had a mean ± SD age of 12.7 ± 2.7 years, diabetes duration of 6.0 ± 3.6 years, and hemoglobin A1c of 7.9 ± 0.8%. Of 985 study visits, 50% received a pubertal status assignment based on clinical Tanner staging, 29% on additional medical record review, and 22% on an evaluation of height velocity and growth chart trajectory. For the sensitivity analysis, pubertal status assignments based on height velocity and growth chart trajectory matched clinical Tanner staging in 87% of visits. Conclusions: Our practical and objective method to assess pubertal status based on height velocity and growth chart trajectory highlights growth as a reliable and objective bioassay for pubertal onset, status, and progression.
Authors: Mary Beth Terry; Mandy Goldberg; Sarah Schechter; Lauren C Houghton; Melissa L White; Karen O'Toole; Wendy K Chung; Mary B Daly; Theresa H M Keegan; Irene L Andrulis; Angela R Bradbury; Lisa Schwartz; Julia A Knight; Esther M John; Saundra S Buys Journal: Pediatrics Date: 2016-06-08 Impact factor: 7.124
Authors: Marie Lindhardt Johansen; Casper P Hagen; Mikkel G Mieritz; Ole D Wolthers; Carsten Heuck; Jørgen Holm Petersen; Anders Juul Journal: J Clin Endocrinol Metab Date: 2017-03-01 Impact factor: 5.958
Authors: Ayse Pinar Cemeroglu; Jason P Thomas; Luke T Vande Zande; Nga T Nguyen; Michael A Wood; Lora Kleis; Alan T Davis Journal: Endocr Pract Date: 2013 Sep-Oct Impact factor: 3.443
Authors: Essi Syrjälä; Harri Niinikoski; Helena E Virtanen; Jorma Ilonen; Mikael Knip; Nina Hutri-Kähönen; Katja Pahkala; Olli T Raitakari; Wiwat Rodprasert; Jorma Toppari; Suvi M Virtanen; Riitta Veijola; Jaakko Peltonen; Jaakko Nevalainen Journal: PLoS One Date: 2021-11-18 Impact factor: 3.240