Study on linear growth of children with idiopathic short children (ISS) with Low Insulin-like growth factor 1 (IGFI) at diagnosis: Growth hormone (GH) treatment versus no treatment.

Sohair Elsiddig; Ashraf Soliman; Ahmed khalil; Nada Alaaraj; Hannah Ahmed

ISS is a condition in which the height of the individual is more than 2SD below the corresponding mean height for a given age, sex, and population, in whom no identifiable disorder is present. At presentation, some of these children have relatively low IGF-I levels which theoretically can affect their response to GH therapy. The question is: does GH treatment of these children improve their linear growth compared to no treatment?

Aim: We studied effect of GH therapy (0.035 mg/kg/day) on linear growth and weight gain in ISS children who have low IGF-I (IGF SDS < -1.5)(n =12) at the presentation in comparison with a similar group (n =10) who did not receive GH therapy.

Results: At presentation, the age, HtSDS, BMI, BMISDS, IGFISDS, peak GH response to clonidine provocation, and bone age didn’t differ between the two groups (ISS and low IGFI). After a year of treatment with GH (0.035 mg/kg/day) the HtSDS, daily weight gain and BMI improved significantly in the GH treated group (P < 0.05). The IGFSDS, BMISDS, HtSDS, and difference between HtSDS and mid-parental HtSDS were significantly higher in treated versus not treated group.

1 = at presentation


ISS low IGF1 (No GH treatment) N = 12	Age1	HtSDS 1	BMI SDS1	MPHSDS	HtSDS-MPHSDS1	IGF-I1	IGF1SDS1	Bone age
Mean	10.1	-2.22	-1.18	-0.87	-1.12	100	-1.97	-0.88
SD	2.58	0.43	0.60	0.56	0.34	35.3	0.37	0.81
ISS low IGF1 treated with GH n =10
Mean	10.3	-2.53	-0.65	-1.14	-1.54	101.	-2.00	-1.15
SD	2.16	0.30	0.80	0.60	0.44	31.7	0.19	0.77

P value	0.42	0.07	0.09	0.24	0.10	0.48	0.38	0.26

2 = after 1 year of follow up


ISS low IGF1 (No GH treatment)
	Duration of F/U	GH-P	HtSDS2	BMI SD2	D IGFSD	wt gain g/day	Delta BMISDS	Delta HtSDS	HTSDS2-MPHSD
Mean	15.3	14.	-2.20	-1.30	0.3	9.32	0.45	0.07	-1.76
SD	2.99	4.0	0.34	0.60	0.3	3.70	0.53	0.13	0.24
ISS low IGF1 treated with GH
Mean	13.82	14.	-1.96	-0.24#	1.04#	16.73	0.13	0.41	0.22
SD	2.65	5.5	0.22	0.71	0.7	4.53	0.20	0.14	0.85

P value	0.38	0.5	0.14	0.02*	0.001	0.02*	0.14	0.001	0.004
*= significant treated versus not treated groups# = significant after versus before treatment

Conclusions: GH therapy improved linear growth and weight gain in children with ISS who had low IGF1 at presentation compared to the non-treated control group.

ESPE Abstracts

P1-178