Experience with long-term glucocorticoid treatment in congenital adrenal hyperplasia: Growth pattern compared with genetic height potential

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dc.contributor.authorAycan, Zehra
dc.contributor.authorÖcal, Gönül
dc.contributor.authorBerberoğlu, Merih
dc.contributor.authorÇetinkaya, Ergun
dc.contributor.authorAdıyaman, Pelin
dc.contributor.authorEvliyaoğlu, Olcay
dc.date.accessioned2020-06-25T17:41:03Z
dc.date.available2020-06-25T17:41:03Z
dc.date.issued2006
dc.departmentKırıkkale Üniversitesi
dc.descriptionberberoglu, merih/0000-0003-3102-0242
dc.description.abstractObjective: Long-term replacement treatment with high doses of steroids in congenital adrenal hyperplasia (CAH) is known to have a negative influence on growth. We evaluated the effects of long-term steroid treatment in patients with classical CAH on height development in relation to genetic height potential. Patients and Methods: Twenty-three patients with CAH (16 females, 7 males, mean age: 9.8 +/- 3.5 years) were included in this longitudinal study. The effect of steroid treatment on growth was determined by monitoring patients for 8.61 +/- 3.46 years (2-17 years) while they were treated with hydrocortisone at a mean dosage of 17.64 +/- 3.60 mg/m(2)/day. The height standard deviation scores (Ht-SDS), target Ht-SDS, and corrected Ht-SDS for target height was calculated for all patients. Predicted adult height according to bone age was calculated and it was determined whether height was developing according to the genetic height potential. In addition, patients were grouped as 'tight control' or 'poor control' according to their mean serum 17OH-progesterone or ACTH levels while on treatment. We evaluated whether height development was different for the tight and poor control groups. Results: The mean chronological age of our patients at the time of the study was 9.89 +/- 3.53 years, Ht-SDS -0.77 +/- 1.57, target height (TH) 161.03 +/- 6.54 cm, TH-SDS -0.60 +/- 0.90, predicted height (PH) 157.2 +/- 11.16 cm, PH-SDS -1.1 +/- 1.69, and corrected Ht-SDS -0.75 +/- 1.14. There was no significant difference between the actual Ht-SDS and TH-SDS of our patients (p > 0.05) but the corrected Ht-SDS was less than zero. Only 28.5% of our patients had normal height according to their genetic potential while 71.5% were shorter than their genetic height potential. While the Ht-SDS and corrected Ht-SDS were similar in the tight and poor metabolic control groups, the predicted height was significantly greater in the tight control group. Conclusion: We demonstrated that a hydrocortisone dose of 17.64 +/- 3.60 mg/m(2)/day in classical CAH had a negative influence on height development for genetic height potential in 8.5 years of follow-up and that it is necessary to use the lowest possible steroid dosage by individualizing the dose.en_US
dc.identifier.citationclosedAccessen_US
dc.identifier.endpage251en_US
dc.identifier.issn0334-018X
dc.identifier.issn2191-0251
dc.identifier.issue3en_US
dc.identifier.pmid16607925
dc.identifier.scopus2-s2.0-33645541872
dc.identifier.scopusqualityQ2
dc.identifier.startpage245en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12587/3617
dc.identifier.volume19en_US
dc.identifier.wosWOS:000236479400009
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWalter De Gruyter Gmbhen_US
dc.relation.ispartofJournal Of Pediatric Endocrinology & Metabolism
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectcongenital adrenal hyperplasiaen_US
dc.subjectheight developmenten_US
dc.titleExperience with long-term glucocorticoid treatment in congenital adrenal hyperplasia: Growth pattern compared with genetic height potentialen_US
dc.typeArticle

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