ESPE2014 Poster Category 3 Growth (3) (13 abstracts)
aUniversity of Medicine and Pharmacy, Iasi, Romania; bRomanian Academy of Medical Sciences, Iasi, Romania
Background: GH therapy is being used worldwide to improve height outcome in children with GH deficiency (GHD), with minimal serious side effects. Early diagnosis and therapy initiation optimize growth outcomes.
Objectives: To evaluate growth and safety during the first 4 years of GH treatment in 33 GHD children.
Methods: We reviewed clinical data of 33 prepubertal children (23 boys and ten girls): 30 with isolated GH deficiency (IGHD), three with multiple pituitary hormone deficiency (MPHD). All of them were treated with a mean dose of GH=0.035 mg/kg per day and followed for at least 4 years (mean 5.98 years).
Results: The mean height SDS increased from −2.76 at baseline to −0.73 at 4 years; the change in height SDS decreased with time Table 1. Within first 4 years of therapy none of these children developed diabetes mellitus, seven patients (21.21%) presented transient increase in fasting glucose (>100 <126 mg/dl), two patients (6.06%) had transiently impaired glucose tolerance (<140 <200 mg/dl at OGTT), three patients (9.09%) developed hypothyroidism and one patient (3.03%) had transiently increased TSH levels (normal fT4 values, no clinical signs). No malignancies were observed to date.
Parameter | Baseline | 1 year | 2 years | 3 years | 4 years |
Chronological age (years) | 7.89 | 8.89 | 9.89 | 10.89 | 11.89 |
Bone age (years) | 5.76 | 6.62 | 7.44 | 9.46 | 11.07 |
IGF-1 mean values (ng/ml) | 64.64 | 221.8 | 205.7 | 265 | 338 |
Height SDS | −2.76 | −2.12 | −1.55 | −1.14 | −0.73 |
Height velocity (cm/year) | | 10.59 | 7.48 | 6.04 | 6.76 |
Weight SDS | −1.94 | −1.28 | −0.94 | −0.46 | −0.12 |
Conclusions: GH treatment significantly improves growth of GHD children, with a favorable safety profile. The maximum height velocity was observed in the first year of therapy (10.59 cm/year); the following years of treatment resulted in a lower height velocity (7.48 cm/year, 6.04 cm/year, 6.76 cm/year respectively). No severe adverse events were observed.