ESPE Abstracts (2016) 86 P-P2-866

Endocrine and Metabolic Parameters before Onset of rGH Treatment: Potential Predictive Factors of GH Response in Children Born SGA? Results from Cohort of Nancy

Emeline Renard, Carole Legagneur, Julie Auger, Béatrice Lebon-Labich, Cédric Baumann & Bruno Leheup


Medecine Infantile, Nancy, Lorraine, France


Background: In spite of many studies demonstrating efficiency of recombinant growth hormone (rGH) on adult height in children born small for gestational age (SGA), great variability of response exists between treated patients. Predictive factors have been already studied such as age at start of treatment, rGH dose,…, but few data are available regarding the predictive values of pretherapeutic data on growth response.

Objective and hypotheses: The main objective of this study is to identified predictive factors of rGH response in children born SGA with specific focus on clinical and biological data, especially regarding weight evolution, during the first years of life before the onset of treatment.

Method: This is retrospective and monocentric study in hospital of Nancy. rGH response is defined by variation of height DS measured at 1, 2 years of treatment, at the end of treatment and at final adult height. Clinical and biological data before and during GH treatment were collected in files of treated children. Bivariate and multivariate analysis were performed.

Results: In total of 108 children born SGA received GH treatment in Nancy, 91 patients were included. Amplitude of rGH response at final adult height is significantly positively correlated with pretherapeutic cholesterol (r=1.64; P=0.0341), not significantly with HDL cholesterol (r=3.13; P=0.0705), significantly negatively correlated with pretherapeutic cortisol (r=−0.02; P=0.0217), and negatively correlated with T4 (−0.31; P=0.0417) in bivariate analysis. At 2 years of treatment, rGH response is significantly positively correlated with TSH before onset of treatment (r=1.1; P=0.0204) in multivariate analysis. No statistical correlation was found with weight evolution first years of life.

Table 1. (for abstract P2-P866)
7.4.103.12.1021.3.1131.10.1111.11.1313.8.1416/2/156/11/15
HtSDS (Turner)−2.01−2.08−1.95−1.29−0.57−0.54−0.64−0.39
HtSDS (nonTurner)−3.97−3.95−3.84−3.21−2.59−2.6−2.7−2.58
IGF1 49.7 (3.3–31.7)46.2 (3.3–31.7)48.2 (5.1–48.2)50.2 (5.1–48.2)
GH (mg/m2/wk)4.278.49.55.84.95.6

Conclusion: This study highlights potential implication of thyroid, adrenal function and lipid profil on rGH response in children born SGA. Absence of association with weight evolution may be due at lack of statistical power, further studies with larger size are needed.

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