ESPE Abstracts

Introduction: A multicenter clinical trial in the US showed that underweight small for gestation (SGA) children responded to GH treatment like non-underweight SGA children. However, data on GH response in short underweight children with the normal birth size is not studied well.

Aim: To measure growth response to GH therapy in underweight children versus short normal-weight children with idiopathic short stature (ISS) born appropriate for gestational age (AGA)

Methods: We studied 52 short prepubertal children (HtSDS <-2 born AGA (i.e. normal birth weight and/or length for their gestational age) with normal growth hormone peak to provocation, thyroid, hepatic and renal function, and hemogram and negative celiac screening. 15 were underweight at presentation (BMI SDS <-2) and 37 had normal (BMISDS >-1.5). Both groups received rhGH at 0.03: 0.05 mg/kg/day for 1 year. In addition, underweight children had nutritional counseling and supplementation. Anthropometric data {height (Ht), weight (W), HtSDS and BMISDS} and insulin-like growth factor 1 (IGF1) were evaluated and recorded for all the children before and after GH therapy.

Results: Before treatment with GH the age, HtSDS, and bone age did not differ between the 2 groups. The difference between HtSDS and Mid-parental HtSDS (MPHSDS) did not vary between the two groups. IGF1 was significantly lower in the underweight group versus the normal weight group. After a year of GH treatment, the BMISDS did not change significantly in both groups. The HtSDS and IGFSD increased significantly in the normal weight group but not in the underweight group. The difference between the HtSDS and MPHSDS decreased significantly in the normal weight versus the underweight group.

Conclusion: GH therapy increased significantly the IGF1 concentration and HtSDS in prepubertal children with ISS and normal BMI but not in underweight short children (BMI<-1.5). Underweight children with ISS who received GH therapy grew at a normal growth rate without catch-up in height.