Background: GH revolutionised treatment of children with GH deficiency, conditioning an improvement in height outcome but also an increase of lean body mass and reduction of fat mass.
Objective and hypotheses: The authors aimed to evaluate the growth and weight response in children with GH deficiency and identify potential factors affecting the outcome of these patients.
Method: The growth and weight data of 58 children (33 boys and 25 girls) with GH deficiency, treated with 0.033±0.004 mg/kg per day of GH, for 5.4±3.1 years, were retrospectively analysed. 62.1% of the studied population had idiopathic GH deficiency (IGHD) and 37.9% had organic GH deficiency (OGHD). Statistical analysis:SPSS (21).
Results: At onset, chronological age was 11.6+2.3 years in children with IGHD and 10.6+4.2 years on those with OGHD. The S.D. score of growth velocity (GV) at 1st year was only negatively correlated to age at the onset of therapy (r=−0.56, P=0.008). 23 (39.7%) patients achieved the predicted target height based on mid-parental height (15 boys with 168±5 cm and eight girls with 155±2 cm). Final height S.D.s was positively correlated with initial height-S.D.s (r=0.35, P=0.009) and with target height-S.D.s (r=0.44, P=0.001). Final height-S.D.s was not significantly different between IGHD and OGHD (−1.6±0.8 vs −1.8±1.1, P>0.05). GH treatment was also associated with a slight increase of S.D.s-BMI, either in patients with OGHD (+0.21±0.96) or IGHD (+0.12±0.87). When S.D.s-BMI variation was analysed according to initial weight status, only underweight and normal weight children increased their BMI-S.D.s (0.70±1.5 and 0.15±0.87 respectively) whereas obese ones decreased their BMI-S.D.s (−0.07±0.55).
Conclusion: More than one-third of the children with GH deficiency achieved a final height comparable to their genetic potential. The most significant determining factors were childrens age (influencing GV during 1st year) and height at the onset of the treatment. Our study also confirmed that long term GH treatment contributes to normal weight status, particularly in children that are underweight or obese.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology