The availability of biosynthetic growth hormone (GH) ensures that children who are deficient can have replacement therapy, but it also has created the opportunity to treat children who are short but do not have a deficiency. Non-GH deficient short stature, without treatment, the height outcomes in most studies have failed to reach mid-parental target height. GH therapy resulted in mixed height outcomes; some reached genetic target height whereas others failed. The aim of this study was to report the outcome of the included cases with initial height below - 2 S.D. score, normal stimulated GH levels (>10 μg/l), and treatment with biosynthetic GH for at least one year. That was retrospective study included patients with the inclusion criteria for one year attending pediatric endocrine clinic in Sidra Medicine, Doha,Qatar from January 2017 till January 2018. Results showed 20 children, 15 males and 5 females aged 4.3 to 13.8 years with mean peak GH of 15.58±6.95 μg/l received GH for duration of 2.49±1.61 years with the average GH dose 0.04 mg/kg per day. The mean Mid Parental Height Standard Deviation Score (MPHSDS) was - 1.23±0.57 S.D.. The pubertal stage at presentation was 15 Tanner 1 and 3 Tanner 2 and 2 at tanner 3 increased average 1.3 in 2.5 years. There was no bone age delay with bone age difference of - 0.13±0.67 years. The mean HSDS at start of treatment was −2.33±0.41 and after one year of treatment was −1.83±0.48 with 0.5 S.D. change and at the last visit was −1.56±0.54 with 0.75 S.D. change. The average deviation from MPHSDS was −1.08 S.D. at start versus −0.3 S.D. at the last visit. IGF-1 levels S.D. changed from −0.9±0.6 to be 0.1±0.2 S.D. The increment in HSDS was positively correlated with the increment in IGF-1 levels (P=0.018 and r=0.6).
|Start of treatment||On lat visit||Differences|
|Age in years||Mean||9.88||12.36*||2.49|
|*P < 0.05|
Conclusion: Growth hormone therapy benefits short children with normal growth hormone secretion achieve normal HSDS and approach MPHSDS. The IGF-1 increment correlates with the HSDS increment.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology