Endocrine Abstracts

JOINT792

Background: Advanced bone age (ABA) is a critical determinant of linear growth and final adult height in children with untreated conditions such as idiopathic short stature, precocious puberty, and chronic illnesses. This review evaluates the impact of ABA on height outcomes and its contributing factors, categorized into growth potential, primary drivers, untreated risks, and mitigating strategies. Quantified impact scores provide insights into the relative significance of these factors.

Objectives: 1. To assess the effects of ABA on linear growth and final height potential in untreated cases.

2. To quantify the relative impacts of growth potential, primary drivers, untreated risks, positive outcomes, and key therapies.

3. To evaluate strategies for mitigating ABA-associated growth deficits.

Methods: A comprehensive review of peer-reviewed studies from 1991 to 2025 was conducted. Studies addressing untreated cases of ABA and its impact on linear growth and adult height were included. The analysis involved calculating percent impacts for key categories, classified as small, medium, or high, to contextualize their significance.

Results: • Impact on Height: ABA had a high impact (32. 8%) on reducing final height potential, primarily due to premature epiphyseal fusion and diminished growth velocity.

• Primary Drivers: Hormonal imbalances, including elevated IGF-I and sex steroids, contributed a moderate impact (28. 7%), influencing bone maturation and growth cessation.

• Untreated Risks: Progressive growth failure, earlier puberty onset, and psychosocial challenges presented a high impact (34. 9%) on overall height potential and quality of life.

• Positive Outcomes: Some untreated cases with slower ABA progression preserved final height within target ranges, contributing a small impact (14. 5%) on mitigating growth deficits.

• Key Therapies: Interventions like GnRH agonists and nutritional management showed potential for reversing growth deficits, though effectiveness in untreated cases remains limited, with a moderate impact (24. 1%).

Discussion: ABA significantly compromises linear growth and final adult height in untreated cases. Its high impact on growth potential and untreated risks highlights the importance of early diagnosis and intervention. Hormonal imbalances and premature epiphyseal closure are primary drivers of height deficits. While positive outcomes are rare in untreated cases, targeted therapies can mitigate risks and preserve growth potential when implemented early.

Conclusion: ABA has a profound impact on final adult height in untreated conditions, primarily through premature growth cessation and progressive risks. Early identification and timely therapeutic interventions are essential to mitigate its effects and improve growth outcomes.

Keywords Advanced Bone Age, Linear Growth, Final Height, Untreated Risks, Growth Potential, Hormonal Imbalances.