Abstract
It has been proposed that testosterone-induced growth produces a disproportionate increase in trunk length. Since there is increased adrenal androgens in CAH from early fetal life which may continue intermittently postnatally, disproportionate growth might be expected. Body proportions were measured in 27 CAH patients (19F, 8M; 3 late-onset) aged 4-21 yr (CA) who had been treated with hydrocortisone 15-20 mg/m2/day in infancy and childhood, and dexamethasone 0.25 - 0.75 mg/day in later life. Bone age (BA) determined by the TW2 method was in advance of CA in all but one patient. Statural growth was complete in 9. Standard deviation scores (SDS) were calculated for sitting height (SH) and sub-ischial leg length (SLL). SH (SDS) and SLL (SDS) for CA were −0.47 ± 1.44 (mean ± SD) and −0.49 ± 1.10, respectively; when related to BA the scores were more negative (-1.32 ± 1.28 and −1.1 ± 1.19, respectively). The difference between the scores (SH (SDS) - SLL (SDS), equivalent to 0 in perfect proportion) was 0.01 ± 0.95 indicating normal body proportions. The exception was an untreated, late-onset girl whose SDS difference was +2.1, indicating disproportionate trunk growth. When stature is below normal in CAH, it is generally proportionate. Androgen-induced disproportionate growth only arises postnatally and after chronic androgen excess.
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Young, M., Ribeiro, J. & Hughes, I. 155 BODY PROPORTIONS IN CONGENITAL ADRENAL HYPERPLASIA (CAH). Pediatr Res 24, 543 (1988). https://doi.org/10.1203/00006450-198810000-00176
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DOI: https://doi.org/10.1203/00006450-198810000-00176