Carla Bizzarri, Rita Ortolano, Silvia Einaudi, Mariangela Chiarito, Tommaso Aversa, Mariacarolina Salerno, Federico Baronio, Laura Guazzarotti, Angela Alibrandi, Maria Felicia Faienza, Domenico Corica, Donatella Capalbo, Barbara Baldini Ferroli, Enrica Abrigo, Malgorzata Wasniewska, Anna Grandone, Antonio Balsamo, Antonietta Spinuzza, Gianni Russo, Letteria Morabito, Wasniewska, M. G., Morabito, L. A., Baronio, F., Einaudi, S., Salerno, M., Bizzarri, C., Russo, G., Chiarito, M., Grandone, A., Guazzarotti, L., Spinuzza, A., Corica, D., Ortolano, R., Balsamo, A., Abrigo, E., Baldini Ferroli, B., Alibrandi, A., Capalbo, D., Aversa, T., and Faienza, M. F.
Background: Children with nonclassical congenital adrenal hyperplasia (NCCAH) often present increased growth velocity secondary to elevation of adrenal androgens that accelerates bone maturation and might compromise adult height (AH). Objective: The aim of the study was to analyze prognostic factors affecting growth trajectory (GT) and AH in children with NCCAH. Methods: The study was a retrospective, multicentric study. The study population consisted of 192 children with a confirmed molecular diagnosis of NCCAH, followed by pediatric endocrinology centers from diagnosis up to AH. Clinical records were collected and analyzed. AH (standard deviation score; SDS), pubertal growth (PG) (cm), GT from diagnosis to AH (SDS), and AH adjusted to target height (TH) (AH-TH SDS) were evaluated as outcome indicators using stepwise linear regression models. Results: The stepwise linear regression analysis showed that AH and AH-TH were significantly related to chronological age (CA) (p = 0.008 and 0.016), bone age (BA)/CA ratio (p = 0.004 and 0.001), height (H) (p < 0.001 for both parameters) at NCCAH diagnosis, and TH (p = 0.013 and p = 0.002), as physiologically observed, and was positively related to height (p = 0.027), negatively to BMI (p = 0.001) and BA/CA ratio (p = 0.001) at NCCAH diagnosis. Gender, genotype, biochemical data, and hydrocortisone treatment did not significantly impair height outcomes of these NCCAH children. Conclusions: The results of this study suggest that AH and GT of NCCAH patients are mainly affected by the severity of phenotype (CA, BA/CA ratio, and H) at the time of diagnosis.