# Transforming tallness: how sex steroids influence final height in Marfan syndrome

## TL;DR

This study shows that early low-dose steroid treatment reduces final height in tall individuals, including those with Marfan Syndrome, while minimizing side effects.

## Contribution

The study demonstrates that early steroid treatment significantly reduces final height in tall individuals with Marfan Syndrome.

## Key findings

- Early treatment before age 10 with estrogen led to a height gain of 13.92 cm.
- Low-dose steroid treatment reduced final height in patients with tall stature and Marfan Syndrome.
- Treatment during pre-puberty resulted in greater height gains compared to treatment during puberty.

## Abstract

To evaluate the effects of hormonal treatment with sex steroids on the final height of patients with tall stature, including those diagnosed with Marfan Syndrome (MS), over 15 years in an outpatient setting.

This retrospective cohort study reviewed the medical records of patients referred for tall stature. Descriptive statistics characterized the samples, while independent and paired t-tests assessed changes in final height (FH) and height at the start of treatment (HTS). One-way analysis of variance (ANOVA) evaluated the impact of chronological age at the initiation of therapy, bone age at the start of treatment, and pubertal stage on FH and HTS.

A total of 55 individuals with tall stature (51 % male) were included, among whom 35 (64 %) had clinically confirmed MS. Of these, 34 (62 %) received low-dose steroid treatment. Patients treated during pre-puberty exhibited an average height increase of 25.56 cm (95 %CI 20.40–30.73; p < 0.001; d = 2.86), while those treated during puberty showed an average gain of 11.93 cm (95 %CI 8.69–15.18; p < 0.001; d = 1.72). Early treatment before the age of 10 resulted in height gains of 13.92 cm (95 %CI 4.90–22.93; p = 0.006; d = 1.82) with estrogen and 6.8 cm (95 %CI 1.71–11.88; p = 0.010; d = 0.73) with testosterone.

Early intervention with low doses of steroids significantly reduced final height in individuals with tall stature, including those with MS, while also minimizing dose-dependent adverse effects.