Introduction: Short stature is defined as stature less than −2 standars deviations (SD) for a persons age and sex of the reference population. Short for gestational age children (SGA) represent 20% of all children with short stature. 10% of these can not catch-up and remains their height below −2 SD. Growth hormone (GH) treatment is a recognized therapy for SGA children authorized in Europe at 4 years old. There are studies that support that younger children are more responsive to therapy. For this reason we have carried out a review of the SGA children treated with GH in our hospital.
Methods: Retrospective descriptive study of SGA children treated with GH from 2010 to 2017. We aimed to assess the anthropometric data at the beginning and after one year of treatment.
Results: The review includes 81 patients (58% males). 12.3% were multiple-gestations and 33.3% premature. The mean birth weight was −1.95 SD and the length −2.80 SD. 92.5% of the children had a birth length less than −2 SD, 58% a weight less than −2 SD, and in 49.8% both measures were below −2 SD. The mean age at the beginning of treatment was 6.08 years with a height of −2.91 SD and a height velocity of −1.65 SD. After one year of therapy we observed an increase in both parameters: −2.09 and 3.25 respectively and approximately 54% of the patients reached a height greater than −2 SD (80% of them under 6 years). We observed a significant relationship between younger children and better treatment response (referred to: difference of SD after one year of treatment, height velocity and adult height prediction). The average GH dose initially was 0.038 mg/kg/day. We couldnt prove relationship between GH dose and higher height velocity. We couldnt prove relationship between increased delayed bone age and a greater response to treatment. Regarding the insulin resistance parameters, an average basal insulin increase of 4.48 to 8.63 was observed without an increase in glycaemia or hemoglobin A1C levels.
Conclusions: GH therapy is effective in SGA children with an increase of almost 1 SD after one year of treatment, increase in height velocity and adult height prediction.
1. Increases basal insulin levels but does not alter the other analytical parameters. 2. A greater treatment response is observed in younger children. 3. The greater delay in bone age is not related to a greater treatment response.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology