ESPE Abstracts

Background: Although the beneficial effects of GH treatment on statural growth are well known, the impacts on skeletal maturation are not fully understood. In the current study, we aimed to investigate the progression of bone age (BA) in children with idiopathic GH deficiency (iGHD) and idiopathic short stature (ISS) based on a LG Growth Study (LGS). We also evaluated the progression rate of BA relative to chronologic age (CA) between iGHD and ISS and to find their associated factors

Methods: A total of 93 children (79 with iGHD and 17 with ISS) were analyzed from LGS. All patients included in the study were being treated with recombinant human GH (Eutropin) and their BA was assessed using the Greulich and Pyle method at baseline and every year during first three years of GH therapy.

Results: The means of chronological age (CA) was 7.77±2.77 years in iGDH groups and 8.17±2.97 years in ISS group at start of GH treatment. In iGHD groups, the means of height SDS and difference between BA and CA (BA-CA) was −2.45±0.66 and −1.96±0.96 years in iGHD group and −2.60±0.62 and -2.04±1.25 years in ISS group, respectively. In the iGHD group, the BA-CA at the first, second, and third years of treatment was significantly decreased with GH treatment compared to that of at start of treatment which was −1.74±1.05 years, −1.48±1.02 years, and −1.24±1.21 years, respectively. The BA-CA The progression rate of BA was similar every year in iGHD group. In the ISS group, BA-CA at the first, second, and third years of treatment was −1.74±1.05 years, −1.48±1.02 years, and −1.24±1.21 years, respectively. The BA-CA at the second, and third years of treatment decreased significantly whereas the BA-CA at the first year did not decrease significantly. In ISS group, the progression rate of BA decreased significantly and there was no statistical significance. In the GHD group, 65 children were in BA-CA ≥1 year at the start of treatment whereas 46 children were in BA-CA ≥1 year at the third year of treatment.

Conclusion: The progression rate of BA during GH treatment is significant although clinically acceptable. Clinicians should be considered when efficacy of GH treatment is evaluated.