Height velocity in the detection of growth disorders reconsidered: a retrospective analysis of the DONALD study

Ibrahim Duran; Maja Zimmermann; Jonathan Buggisch; Heike Hoyer-Kuhn; Ute Alexy; Eckhard Schoenau

doi:10.1515/jpem-2025-0225

Article

Height velocity in the detection of growth disorders reconsidered: a retrospective analysis of the DONALD study

Ibrahim Duran , Maja Zimmermann , Jonathan Buggisch , Heike Hoyer-Kuhn , Ute Alexy and Eckhard Schoenau

Published/Copyright: June 20, 2025

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From the journal Journal of Pediatric Endocrinology and Metabolism

Abstract

Objectives

To generate current reference values for height velocity (HV, cm/year) in German children and adolescents and to evaluate the sensitivity of auxological parameters in the evaluation of short stature (referral criteria).

Methods

The study population consisted of healthy German participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study (1985–2022). In total, data was available from n=453 girls (mean age 9.1 ± 2.4 years) and n=473 boys (mean age of 9.6 ± 2.5 years). As the participants were measured repeatedly, 4,557 HV assessments for girls and 5,224 HV assessments for boys were analyzed (median number of observations in female was nine and in male 11). The reference percentiles were created using the LMS method. The referral criteria of the German Society for Pediatric and Adolescent Endocrinology and Diabetology (DGPAED) and of the Growth Hormone Research Society (GHRS) for further endocrinological evaluation were evaluated in a subsample.

Results

The specificity of the referral criteria “HV<25th centile for 1 year” (DGPAED) was 10.4 % in girls and 4.3 % in boys. When this criterion was changed to “HV<3rd centile for 1 year” the specificity increased to 75.5 % in girls and 76.1 % in boys. With omission of the 5th criterion (“height> −2.0 SD AND HV< −2.0 over 1 year”) of the six referral criteria of the GHRS, the specificity of the remaining five referral criteria was 91.4 % in girls and 90.5 % in boys.

Conclusions

New reference centiles for HV are presented. With modification of the already proposed GHRS criteria, the specificity of the assessment of HV in the evaluation of short stature could be increased significantly.

Keywords: children; adolescents; height velocity; reference centiles; referral criteria; specificity

Corresponding author: PD Dr. Ibrahim Duran, Center of Prevention and Rehabilitation, University of Cologne, University of Cologne, Medical Faculty and University Hospital, UniReha, Lindenburger Allee 44, 50931 Cologne, Germany; and Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany, E-mail: Ibrahim.duran@unireha-koeln.de

Ute Alexy and Eckhard Schoenau contributed equally to this work.

Funding source: Ministry of Science and Research of North Rhine-Westphalia

Acknowledgments

We would like to thank the families and children who took part in the DONALD study and made this study possible.

Research ethics: The DONALD study was approved by the Ethics Committee of the University of Bonn, Germany (project identification: 185/20), according to the guidelines of the Declaration of Helsinki (https://drks.de/search/de/trial/DRKS00029092).
Informed consent: Informed consent from the legal representatives of the parents and older participants (>15 years) themselves were obtained.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: All authors declare that they have no conflict of interest.
Research funding: The DONALD study is financially supported by the Ministry of Science and Research of North Rhine-Westphalia, Germany.
Data availability: Restrictions apply to the availability of some or all data generated or analyzed during this study to preserve patient confidentiality or because they were used under license. The corresponding author will on request detail the restrictions and any conditions under which access to some data may be provided.

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Received: 2025-04-23

Accepted: 2025-06-06

Published Online: 2025-06-20

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https://doi.org/10.1515/jpem-2025-0225

Keywords for this article

children; adolescents; height velocity; reference centiles; referral criteria; specificity