Pubertal, Auxological, and Adult Height Outcomes in Children Treated for Adrenocortical Tumors: Half a Century Experience.

IF 2.6 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Fernanda Bora Moletta, Maria Cláudia Schmitt Lobe, Suzana Nesi França, Luiz de Lacerda, Rosana Marques Pereira
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Abstract

Introduction: Most children with adrenocortical tumors (ACTs) present with accelerated growth and skeletal maturation at diagnosis, which potentially compromises their adult heights (AHs). Knowledge about growth and pubertal patterns after ACT resection is scarce. This study presents the pubertal and auxological development of patients treated for ACT and followed up at a single pediatric endocrinology service in Brazil.

Methods: Retrospective cohort study including 63 patients (47 girls) followed up between 1966 and 2021. Pubertal and auxological data from ACT diagnosis to AH were analyzed.

Results: At diagnosis, the patients had median values of bone age (BA) more advanced than chronological age (CA), height standard deviation score greater than target height (TH-SDS), and predicted adult height (PAH-SDS) lower than TH-SDS. The difference between BA and CA decreased gradually during follow-up and the PAH-SDS moved closer to the TH-SDS 7 years after tumor resection. Puberty started at a median CA of 9.3 (8.3-11.3) years in girls and 9.9 (9.2-13.6) years in boys. Nine patients (6 girls) developed central precocious puberty (CPP), which was influenced by a CA >4 years at diagnosis. The difference between AH-SDS and TH-SDS was not significant (p = 0.3). The factors independently associated with AH below TH were CA >4 years at diagnosis, time between clinical manifestation and diagnosis >1 year, and development of CPP.

Conclusion: Most patients treated for ACT during childhood attained AH within the TH despite presenting with advanced skeletal maturation at diagnosis. Development of CPP was not infrequent.

肾上腺皮质肿瘤患儿的青春期、辅助生殖和成年身高结果:半个世纪的经验
简介大多数肾上腺皮质肿瘤(ACT)患儿在确诊时生长和骨骼成熟加速,这可能会影响他们的成年身高(AH)。有关肾上腺皮质肿瘤切除术后的生长和青春期模式的知识很少。本研究介绍了在巴西一家儿科内分泌科接受治疗和随访的ACT患者的青春期和辅助发育情况:方法:回顾性队列研究,包括 1966 年至 2021 年间随访的 63 名患者(47 名女孩)。分析了从ACT诊断到AH的青春期和辅助生殖数据:确诊时,患者骨龄(BA)的中位值高于实际年龄(CA),身高标准偏差评分(H-SDS)高于目标身高(TH-SDS),预测成人身高(PAH-SDS)低于TH-SDS。随访期间,BA和CA之间的差异逐渐缩小,肿瘤切除7年后,PAH-SDS更接近TH-SDS。女孩青春期开始时的 CA 中位数为 9.3(8.3-11.3)岁,男孩为 9.9(9.2-13.6)岁。九名患者(六名女孩)出现了中枢性性早熟(CPP),受诊断时 CA > 4 岁的影响。AH-SDS和TH-SDS之间的差异不显著(P=0.3)。与AH低于TH独立相关的因素是诊断时的CA> 4年、临床表现与诊断之间的时间> 1年以及CPP的发展:结论:大多数在儿童期接受ACT治疗的患者,尽管在确诊时骨骼发育已经很成熟,但其AH仍低于TH。结论:大多数在儿童期接受 ACT 治疗的患者,尽管在确诊时骨骼已经发育成熟,但仍能在 TH 范围内达到 AH。
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来源期刊
Hormone Research in Paediatrics
Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS
CiteScore
4.90
自引率
6.20%
发文量
88
审稿时长
4-8 weeks
期刊介绍: The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.
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