Human Growth and Development

Human Growth and Development
Centro Studi Auxologici - 50123 Firenze - Piazza Madonna degli Aldobrandini 1
Prof. Dott. Ivan Nicoletti Tel. +39 055 212322
Assessment of normal growth and development
Diagnosis and treatment of disorders in growth and development
Common anomalies
Short stature
Overweight and obesity
Delayed puberty
Precocious puberty
Hypogenitalism
Decline in school performance
Behavioral changes due to emotional disorders
Auxological counseling
The Center provides check-ups on normal child development and assesses growth alterations in height, weight, bodily proportions, and maturation times. Normality of growth is judged in terms of standards updated and adapted to the Italian population
Skeletal maturity and prediction of adult stature
The assessment of skeletal maturity and the prediction of adult stature are essential for diagnosis and prognosis and for monitoring anabolic and hormonal therapies. The Center determines skeletal maturity and probable adult height by methods devised by the Center itself.
Scientific research
In collaboration with other research institutes and public organizations, the Center conducts studies on various aspects of child and adolescent development, including physical activity and sports, and publishes its findings in scientific books and articles.
From IXth International Congres of Auxology - year 2000
EARLY PUBERTY AND CENTRAL PRECOCIOUS PUBERTY IN GIRLS: AUXOLOGICAL AND ENDOCRINE-GYNAECOLOGICAL CRITERIA FOR TREATMENT WITH LHRH ANALOGUES Ivan Nicoletti (a), Vincenza Bruni (b), Marta Brachi (b), Luca Tafi (a), Silvano Milani (c)
a) Centro Studi Auxologici - Firenze
b) Clinica Ostetrica e Ginecologica - Università di Firenze
c) Istituto di Statistica Medica e Biometria - Università di Milano.
BACKGROUND.
Central precocious puberty and early puberty are defined as the appearance of Tanner's stage 2 for both pubic hair and breasts before the age of 8 or between the ages of 8 and 9, respectively, without organic causes and in the absence of pathological conditions, such as congenital adrenal hyperplasia, hypothyroidism or growth hormone deficiency.
AIM.
To evaluate somatic growth in girls who have experienced an early or idiopathic precocious occurrence of puberty with or without treatment with an LHRH analogue. PATIENTS AND METHODS.
The study includes 41 girls whose puberty began between 5.2 and 8.7 years of age. These girls were divided into two groups: the first (group HR) included girls considered at high risk of not reaching a final stature falling within the target range (target range was defined as ±1.28 SD of the mean target height), and the other group (LR) was made up of girls considered to be at low risk. A girl was assigned to group HR if she met at least 3 out of 4 auxological criteria and 2 endocrine-gynaecological criteria.
Auxological criteria:
(1) skeletal maturity > 80th centile;
(2) height SDS - target height SDS > 1.0;
(3) presence of height growth spurt;
(4) presence of skeletal maturity spurt.
Endocrine-gynaecological criteria:
(1) positive pubertal GnRH (LH peak > 4 x basal value);
(2) signs of development (transitional uterus or microcystic ovary) at ultrasound examination.
HR girls were given Triptorelin for 12 to 48 months; the treatment was suspended when the ratio of the increase in skeletal age to the increase in chronological age fell below 0.5.
RESULTS.
All girls aged over 13 at the last visit (19 out of 27 HR girls, 10 out of 14 LR) showed height values within the target range, with the only exception of a HR girl, and their mean height was by far greater than the mean of untreated historical controls.
COMMENTS.
The criteria here adopted seem to be suitable for identifying those girls whose somatic growth is not affected by the early appearance of puberty (even before the age of 8 years) and, as a consequence, do not need LHRH treatment.
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