Relationship of Somatomedin-C Concentration to Bone Age in Boys With Constitutional Delay of Growth FREE

Karen R. Rubin, MD; Jenifer M. Lichtenfels, MD; Susan K. Ratzan, MD; Maer Ozonoff, MD; David W. Rowe, MD; Dennis E. Carey, MD

[+] Author Affiliations

Accepted for publication Jan 9, 1986.

Reprint requests to Department of Pediatrics, Newington Children's Hospital, 181 E Cedar St, Newington, CT 06111 (Dr Carey).

Am J Dis Child. 1986;140(6):555-558. doi:10.1001/archpedi.1986.02140200065029.

Text Size: A A A

Published online

Article

References

Comments

ABSTRACT

ABSTRACT | REFERENCES

• Serum somatomedin-C (Sm-C) levels increase sharply during puberty, leading to difficulty in the interpretation of Sm-C values obtained from children who exhibit a discrepancy between chronological age (CA) and pubertal development. To evaluate the utility of assessing Sm-C levels on the basis of bone age (BA), we measured serum Sm-C levels in 44 boys with constitutional delay of growth (CDG). Levels of Sm-C were compared with the normative data of the Nichols Institute Reference Laboratories (NIRL), Los Angeles, by age category, substituting BA for CA. We found the mean Sm-C level in boys with CDG to be lower than that for NIRL normal subjects in each age category for both CA and BA, but the regression curve for Sm-C levels based on BA more closely approximated the NIRL regression curve than did the curve based on CA. The rise in Sm-C levels observed in NIRL normal subjects between CA 13 to 14 years is delayed in boys with CDG until CA 15 to 17 years only when a correction for BA is not made. We conclude that in boys with CDG, Sm-C levels should be interpreted on the basis of BA rather than CA, especially during the peripubertal period. The observation of blunted Sm-C levels in all age categories, even when BA was used, suggests that short children with presumed CDG may be at high risk for a "nonclassic" form of growth hormone deficiency.

(AJDC 1986;140:555-558)

REFERENCES

ABSTRACT | REFERENCES

Horner JM, Thorsson AV, Hintz RL: Growth deceleration patterns in children with constitutional short stature: An aid to diagnosis . Pediatrics 1978;;62:529-534.

Van Vleet GV, Styne DM, Kaplan SL, et al: Growth hormone treatment for short stature . N Engl J Med 1983;;309:1016-1022.

Gertner JM, Genel M, Gianfredi SP, et al: Prospective clinical trial of human growth hormone in short children without growth hormone deficiency . J Pediatr 1983;;104:172-176.

Frazer T, Gavin JR, Daughaday WH, et al: Growth hormone–dependent growth failure . J Pediatr 1982;;101:12-15.

Rudman D, Kutner MH, Blackstan RD, et al: Children with normal-variant short stature: Treatment with human growth hormone for six months . N Engl J Med 1981;;305:123-131.

Tanner JM: Human growth standards: Construction and use , in Gidden L, Parisi P (eds): Auxology: Human Growth in Health and Disorders . Orlando, Fla, Academic Press Inc, 1978;, pp 109-121.

Greulich WW, Pyle SJ: Radiographic Atlas of Skeletal Development of the Hand and Wrist , ed 2. Stanford, Calif, Stanford University Press, 1959;.

Tanner JM, Whitehouse RH: Longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty . Arch Dis Child 1976;;51:170-179.

Luna AM, Wilson DM, Wibbelsman CJ, et al: Somatomedins in adolescence: A cross-sectional study of the effect of puberty on plasma insulin-like growth factor I and II levels . J Clin Endocrinol Metabol 1983;;57:268-271.

Parker MW, Johansen AJ, Rogol AD, et al: Effect of testosterone on somatomedin-C concentrations in prepubertal boys . J Clin Endocrinol Metabol 1984;;58:87-90.

Copeland RC, Johnson DM, Kuehl TJ, et al: Estrogen stimulates growth hormone and somatomedin-C in castrate and intact female baboons . J Clin Endocrinol Metabol 1984;;58:698-703.

Bala RM, Lopatka J, Leung A, et al: Serum immunoreactive somatomedin levels in normal adults, pregnant women at term, children at various ages, and children with constitutionally delayed growth . J Clin Endocrinol Metabol 1981;;52:508-512.

Cacciari E, Cicognanni A, Pirazzoli P, et al: Differences in somatomedin-C between short-normal subjects and those of normal height . J Pediatr 1985;;106:891-894.

Blethen SL, Chasalow FI: Use of a two-site immunoradiometric assay for growth hormone (GH) in identifying children with GH-dependent growth failure . J Clin Endocrinol Metabol 1983;;57:1031-1035.

Valenta LJ, Sigel MB, Lesniak MA, et al: Pituitary dwarfism in a patient with circulating abnormal growth hormone polymers . N Engl J Med 1985;;312:214-217.

Spiliotis BE, August GP, Hong W, et al: Growth hormone neurosecretory dysfunction . JAMA 1984;;251:2223-2230.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal