Growth response to growth hormone therapy in short children in relation to their distance from mid-parental heights (MPHt).

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

In normal children, mid parental height (MPH) is a useful tool in assessing children’s growth and in the prediction of their final adult height. However, this may not be true for short children, especially those with height SD (HtSDS) > - 1SDS compared to their mid-parental height SDS (MPHtSDS). The difference may indicate underlying pathology.

Aim: To assess growth response (change in HtSDS) to GH therapy in short prepubertal children in relation to their MPHtSDS.

Methods: This retrospective study reviewed 42 prepubertal short children with HtSDS <-2. Children classified based on distance from MPHtSDS in two groups. Group1 included children whose HtSDS were 1SDS or more below their MPHSDS (n = 25). Group 2 whose HtSDS less than 1SDS from MPHSDS (n = 17). Their BMISDS, IGF1SDS, bone age and growth velocity (GV), and difference from MPHSDS were measured before and after one year. Sixteen children in Group 1 and 11 children in group 2 were treated with growth hormone therapy (0.03- 0.5 mg/kg/d) subcutaneously to keep their IGF1 SD in the normal range (0 to 2 SD).

Result: Children in group 1 had HtSDS - MPHSDS = -1.72±0.52 while in group 2 the difference was -0.33±0.75. (P <0.01). Children in Group 1 were significantly shorter compared to group 2 (HtSDS (-2.35±0.57) vs. (-1.89±0.61) respectively P = 0.02). There was no statistical difference in BMISDS, IGF1SDS, or bone age at presentation. After One year of GH therapy the HtSDS of children in the group an increased to -2.01±0.59, (P = 0.005), and their difference from MPHSDS improved by (0.67±0.85) P < 0.0000. In group 2 the HtSDS increased to -1.66±0.68, (P < 0.01) and their difference from MPHSDS improved by (0.30±0.32) (P = 0.01)


	Age	HtSDS1	BMISDS1	HtSDS1-MPHSDS	HtSDS2	BMISDS2	HtSDS2-MPHSDS	Delta HtSDS	Delta HtSDS-MPHSDS
Group 1	10.55	-2.35*	-0.84	-1.72*	-2.01	-0.57	-1.38*	0.33	0.67
	2.85	0.57	0.94	0.52	0.59	1.11	0.52	0.52	0.85
#P					0.005	0.9	0.000
Group 2	9.48	-1.89	-0.16	-0.33	-1.66	-0.09	-0.04	0.20	0.30
	3.87	0.61	1.17	0.70	0.68	1.13	0.91	0.30	0.32
#P					0.01	0.2	0.01
*P < 0.05 between the two groups#<0.05 in the same group

Conclusion: This short prepubertal and peripubertal GH therapy had significantly increased their HTSDS and improved the difference between their height and their genetic background (MPHtSDS). Those who had a higher difference compared to MPHTSDS at the beginning had significantly faster correction towards their genetic potential (significant catch up towards the genetic background).

ESPE Abstracts

P2-268