A 5-Year Prospective Study of Growth Hormone (GH)-Deficient Children Treated with GH before the Age of 3 Years

Publisher Website
Google Scholar
Abstract
The aim of the study was to assess the efficacy of GH therapy in GH-deficient children treated before the age of 3 yr. A noncomparative multicenter prospective study included 49 children (22 girls and 27 boys) with isolated GH deficiency (n 5 19) or multiple pituitary hor- mone deficiency (n 5 30) treated with daily sc injections (0.6 U/kgzweek) for 3-5 yr. They were divided into two groups according to their height SD score for chronological age (CA) at the initiation of therapy: group A consisted of 8 patients presenting an initial height within the normal range (,2 SD below the mean) followed for 2-5 yr, and group B consisted of 25 children followed for 5 yr among 41 patients with initial growth retardation. In group A, the mean height SD score increased from 21.1 6 0.6 to 0.35 6 1.0 SD (P , 0.001) in the first year and remained in the normal range throughout the following 4 yr. In group B after 4 yr of treatment, the mean height SD score for age had increased from 23.6 6 1.0 SD (time zero) to 20.9 6 1.2 SD. During the fourth year of therapy, the mean height gain of 0.2 6 0.2 SD was significant (P , 0.001). After 5 yr of treatment, a plateau was reached with a corresponding height SD score (CA) of 20.8 6 1.2 SD (95% confidence interval between 21.3 and 20.2 SD). This value remained significantly below normal for age (P , 0.001), indicating that catch-up growth was incomplete. Only four patients (16%) remained below 22SD for CA. The 5-yr height gain was negatively correlated with the height SD score at the start of treatment (r 52 0.6; P , 0.005) and the first year height gain was the most predictive parameter. There was no significant influence of intrauterine growth retardation, body mass index and age at the start of treatment, or parental target height. Bone maturation was signif- icantly retarded over CA by a mean value of 1.1 6 0.9 yr (P , 0.0001), with a mean bone age/CA ratio of 0.8 6 0.2 after a mean treatment duration of 5.1 6 1.1 yr. In conclusion, the rapid and almost complete return to normal height obtained in this study supports the need for GH treatment in early diagnosed GH-deficient children. The present dosage may be considered the minimum to obtain satisfactory catch-up growth en- suring a favorable outcome for these children. In addition, it allowed growth at a rate normal for age in patients diagnosed before growth retardation. (J Clin Endocrinol Metab 82: 452- 456, 1997)

This publication has 0 references indexed in Scilit: