Height velocity in the detection of growth disorders reconsidered: a retrospective analysis of the DONALD study.

Objectives: To generate current reference values for height velocity (HV, cm/year) in German children and adolescents and to evaluate the sensitivity of auxological parameters in the evaluation of short stature (referral criteria).

Methods: The study population consisted of healthy German participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study (1985-2022). In total, data was available from n=453 girls (mean age 9.1 ± 2.4 years) and n=473 boys (mean age of 9.6 ± 2.5 years). As the participants were measured repeatedly, 4,557 HV assessments for girls and 5,224 HV assessments for boys were analyzed (median number of observations in female was nine and in male 11). The reference percentiles were created using the LMS method. The referral criteria of the German Society for Pediatric and Adolescent Endocrinology and Diabetology (DGPAED) and of the Growth Hormone Research Society (GHRS) for further endocrinological evaluation were evaluated in a subsample.

Results: The specificity of the referral criteria "HV<25th centile for 1 year" (DGPAED) was 10.4 % in girls and 4.3 % in boys. When this criterion was changed to "HV<3rd centile for 1 year" the specificity increased to 75.5 % in girls and 76.1 % in boys. With omission of the 5th criterion ("height> -2.0 SD AND HV< -2.0 over 1 year") of the six referral criteria of the GHRS, the specificity of the remaining five referral criteria was 91.4 % in girls and 90.5 % in boys.

Conclusions: New reference centiles for HV are presented. With modification of the already proposed GHRS criteria, the specificity of the assessment of HV in the evaluation of short stature could be increased significantly.