Adult height in women with early-treated congenital adrenal hyperplasia (21-hydroxylase type): relation to body mass index in earlier childhood



To investigate if obesity, as judged by increased body mass index (BMI), during childhood is associated with impaired adult stature in patients with 21-hydroxylase-type congenital adrenal hyperplasia (CAH), a retrospective analysis was carried out on outpatient records of 30 girls with CAH who had reached adult height. Height SD score for age (HtSDS(ca)), HtSDS for bone age (HtSDS(ba)), BMI and steroid dosage in early childhood (3.2-4.6 years) and later childhood (7.2-9.1 years), were compared with adult HtSDS (HtSDS(adlt)), adult HtSDS less mid-parental HtSDS (HtSDS(adlt) - HtSDS(mp)), predicted adult height SDS (HtSDS(pdct)), adult height SDS less predicted adult HtSDS (HtSDS(adlt) - HtSDS(pdct)) and age at menarche. Mean (SD) for HtSDS(adlt) was -1.13 (1.05), mean HtSDS(pdct) -0.12 (0.9) and mean age at menarche 13.5 (1.9) years. BMI in childhood was not correlated with HtSDS(adlt) but showed negative correlations with HtSDS(adlt) - HtSDS(mp) (r = -0.43; p < 0.02) and HtSDS(adlt) - HtSDS(pdct) (r - 0.45; p < 0.02). BMI in later childhood showed negative correlations with HtSDS(adlt) - HtSDS(pdct) (r = -0.61; p < 0.001) and age at menarche (r= -0.63; p < 0.001). We conclude that in girls with early-treated CAH, a high BMI during early childhood is associated with loss of genetic height potential, and in later childhood with over-prediction of adult height and early menarche.Adult stature, body mass index, congenital adrenal hyperplasia (21-hydroxylase type), predicted adult height

DB Grant, Medical Unit, Institute of Child Health, Guilford Street, London WC1N 1EH, UK