ESPE Abstracts

The aim of this study was to investigate the clinical and laboratory features of patients who received recombinant human growth hormone (rhGH) treatment and to investigate the factors that determine the response to rhGH treatment. The clinical features of children treated at least one year with rhGH were retrospectively analyzed. Patients were grouped according to diagnosis; isolated GH deficiency (IGHD), multiple pituitary hormone deficiency (MPHD), Turner syndrome, other syndromes, idiopathic short stature. In total 268 patients (156 boys, 112 girls) with mean age of 11,3 ±3,07 were included in the study. The mean height standard deviation score (SDS) at diagnosis was -2,73±0,76. Most of the patients (86.1%) were isolated GHD. Abnormal MRI were found in 36 (13.4 %) children. The mean age of diagnosis of patients with MPHD (8.12±4.21) was lower than that of the isolated GHD (11.5±2.8) (p = 0.04). Significantly lower levels of serum insulin-like growth factor-1 SDS were determined in the patients with MPHD than isolated GHD (P = 0.01). The GH stimulation test peak response was significantly lower in patients with MPHD than all of the other groups. A negative correlation was found between the growth rate in the first year and peak response to GH stimulation test, IGF-1 and IGF-1 SDS. A positive correlation was between growth rate (cm/year) in the first year and target height, weight SDS, body mass indeks (BMI) and BMI SDS. A negative correlation was found between the change in height SDS in the first year (first year delta height SDS) and height SDS at the beginning of the treatment, peak GH response to L-Dopa GH stimulation test, IGF-1 SDS. In all group, poor response to treatment was 24.3%. Mean final adult height (FAH) SDS was -1.31 ±0.78 and final delta height-SDS (the change in height SDS between the beginning and end of treatment) was 1.16 ±0.51. FAH was correlated with height SDS at the beginning of treatment, the growth rate in the first year (cm/year) and first year delta height SDS. A positive correlation was found between final delta height SDS and first year delta height SDS (r = 0.40 P < 0.001), growth rate (cm/year) in the first year (r = 0.69, P < 0.001), difference between chronological age and bone age (r = 0.26, P = 0.04). There was a negative correlation between peak GH test response and final delta height SDS (r = -0.19, P = 0.04). As a conclusion, first year delta height SDS and growth rate were the major predictive factors for FAH.