Changes in Length and Weight Standard Deviation Scores in Children with Growth Hormone Deficiency Across Various Studies

Ashraf Soliman; Fawzia Alyafei; Nada Alaaraj; Shayma Ahmed; Anas Abdulkayoum; Noor Hamed; Amal Sabt

Background: The infantile growth parameters of children diagnosed later in life with GH-deficiency is still very controversial.

Methods: We synthesized data from eight key studies, spanning from 1984 to 2003, alongside our current patient data. The LSDS and WtSDS at birth, 2 months, and 24 months are compared, noting the presence or absence of significant growth retardation or deviation from expected growth standards.

Results: Notable variations in LSDS at birth range from median values of -0.87 SDS to normal lengths with subsequent deterioration. By 2 months, two studies report a loss in length SDS of -1.6 and -3.3, respectively, while our patient data indicates a mean LSDS of -2.64. At 24 months, the reported deterioration ranges from -2.25 in our patients to -3.5 at the time of diagnosis in another study, illustrating a spectrum of growth impairment severity.

Discussion: The compiled data reveal a pattern of early and severe growth deficiency in children with GHD, with a pronounced 'catch-down' growth in the first few months. The consistency of reported subnormal LSDS emphasizes the need for early diagnosis and intervention.

Table: Comparison of WTSD and LSDS in the first two years in Children with GHD Across Various Studies
Source	Year	LSDS at Birth	WtSDS at 2m	LSDS at 2m	WtSDS at 24m	LSDS at 24m
Albertsson-Wikland et al.	1990	-0.87 median SDS	NS	NS	NS	Not specified
Wit JM & van Unen H	1992	NS	NS	-3.3 (at 4m)	NS	-4.9 (at 9m)
De Luca et al.	1995	69% had subnormal length	NS	NS	NS	Significant deterioration from birth
Niklasson et al.	1994	-0.87 median SDS	NS	NS	NS	Not specified
Chatelain	1991	NS	NS	Not specified	NS	Early postnatal growth failure
Pena-Almazan et al.	2001	Normal at birth but showed deceleration	NS	-1.6 SD loss over first 6 months	NS	-2.2 SD total loss in the first year
Huet et al.	1999	-0.9 (±1.4)	NS	NS	NS	-3.5 (±1.9 at diagnosis)
Ogilvy-Stuart	2003	Within normal ranges but some profound failure	NS	NS	NS	Early and profound post-natal growth failure
Our Patients	2023	-1.09	-1.65	-2.64	-1.46	-2.25

Conclusion: This comparative analysis underscores the importance of early growth monitoring in children with GHD. The chronological compilation of data highlights the critical nature of the first two years of life in determining long-term growth outcomes. Our findings reinforce the necessity for standardized growth tracking and early therapeutic strategies to address GHD-related growth challenges.

ESPE Abstracts

P1-52