Objective To analyze the role of carpal bone development evaluation in the diagnosis of growth hormone deficiency (GHD),in order to provide basis of diagnosis and treatment of GHD. Methods A total of 82 prepubescent short-statured children who had completed the growth hormone provocative test in child care clinic of International Peace Maternity and Child Health Hospital were enrolled in this study from January 2018 to June 2019,including 41 cases with GHD at chronological age of (5.78±1.49) years old and 41 cases with idiopathic short stature (ISS) at chronological age of (5.17±1.44) years old.Children's bone age was assessed using China 05 method.The ages of radius,ulna,and short (RUS) bone and carpal bone were compared with the chronological age respectively.ROC curve was used to evaluate its role in predicting GHD. Results The carpal bone age in GHD group [(3.88±1.68) years old]was significantly lower than that in ISS group [(4.75±1.47) years old](t=2.48,P<0.05),while significant difference was not found on RUS bone age between the two groups(P＞0.05).Significant delays in bone maturation were both observed in the GHD group using the carpal bone [(1.89±1.05) years old]and RUS bone [(1.13±0.78) years old]assessments,which were higher than those of ISS group [carpal bone:(0.41±1.02) years old,RUS bone:( 0.33±0.86 )years old](t=-4.48,-6.47,P＜0.05).The correlation between maturation delay and GHD in carpal bone (OR=4.208,95%CI:2.246-7.884, P＜0.01) was stronger than that in RUS bone (OR=3.311,95%CI:1.763-6.221, P＜0.01).ROC curve analysis showed that GHD was moderately predicted by the degree of carpal bone maturation delay (AUC=0.840,sensitivity:0.707,specificity:0.854, P＜0.01),and its prediction ability was better than that of RUS bone (AUC=0.746,sensitivity:0.683,specificity:0.756,P＜0.01). Conclusion s Hand bone maturation is helpful for the diagnosis of GHD in preadolescent children.Compared with RUS,carpal bone maturity may be a better reference index for the diagnosis of GHD.
Key words
China 05 /
bone age /
skeleton age /
carpal bone /
growth hormone deficiency
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