Growth patterns in patients with congenital adrenal hyperplasia analyzed by the QEPS growth model

Abstract

Context: Patients with congenital adrenal hyperplasia (CAH) often face challenges in achieving their target adult height. The QEPS growth model, previously used for assessing healthy and pathological growth patterns, has not been applied to individuals with CAH. Objective: To evaluate growth patterns in patients with CAH using the QEPS growth model and to compare their growth characteristics with a healthy reference population. Design: A retrospective longitudinal study analyzing growth data collected from 1986 to 2008.Setting: The study was conducted in a single tertiary care center. Patients: The study included 25 patients (13 girls) with CAH, subtyped into salt wasting (SW; 12 boys, 8 girls) and simple virilizing (SV; 5 girls). Growth data were compared with a healthy reference cohort. Interventions: All patients were treated with hydrocortisone, and patients with CAH-SW received mineralocorticoids. Main outcome measures: Growth patterns were analyzed using the QEPS model, which includes specific early life growth (E-function), basic childhood growth (Q-function), and specific pubertal growth (P-function). Final adult height was compared with the reference population and parental heights. Results: CAH-SW boys and girls were longer at birth, exhibited reduced early-life growth, and had reduced puberty-specific growth (lower Pmax), resulting in shorter adult height (1.7 SDS). CAH-SV girls had earlier pubertal growth onset, also leading to reduced adult height (−1.6 SDS). Both groups showed similar basic childhood growth. Conclusions: Patients with CAH-SW displayed distinct growth patterns, including longer birth length but reduced specific early and pubertal growth, resulting in shorter adult height compared with reference populations and parental heights.