ESPE Abstracts (2019) 92 RFC2.3

Growth Hormone Effects on Metacarpal Bone Geometry and Bone Age in Growth Hormone-Deficient Children

David D Martin1,2, Michael B Ranke3, Hans Henrik Thodberg4, Gerhard Binder3


1University Children's Hospital, Tubingen, Germany. 2University of Witten/Herdecke, Herdecke, Germany. 3University Children's Hospital, Tubingen, Germany. 4Visiana, Hørsholm, Denmark


Purpose: To track the effects of growth hormone on bone geometry and maturation in children with isolated growth hormone deficiency (GHD).

Methods: 299 left hand X-rays from 77 short prepubertal children (54 boys and 23 girls) with isolated GHD were analysed for changes in metacarpal thickness, width, length, medullary diameter, the Bone Health Index (BHI) and bone age (BA) from one year preceding until four years after start of GH treatment using BoneXpert, a fully automatic X-ray analysis software.

Results: Age-related standard deviation scores (SDS) revealed strong and significant stimulatory effects on thickness, length and width, ranking in this order, and no effect on medullary diameter. Height- and BA-related SDS also showed a significant increase in thickness, while length and width increased non-significantly in this regard. BHI increased for age, BA and height. Catch-up growth was strongest in the first year and, for BA, the more pronounced for a parameter the greater the baseline deficit was for that parameter. BA change was slower than change of thickness and height during the first year and thereafter faster, but BA remained delayed even after 4 years.

Conclusion: Children with isolated GHD have decreased metacarpal thickness and delayed bone age. GH treatment leads to a rapid normalisation of the former in the first year of treatment and a slow catch-up of the latter from the second year onwards.

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