ESPE2024 Poster Category 2 GH and IGFs (22 abstracts)
1Department of Pediatrics, Pusan National University Hospital, Busan, South Korea. 2Department of Pediatrics, Good Moonhwa Hospital, Busan, South Korea. 3Department of Pediatrics, Pusan National University School of Medicine, Pusan National University Children’s Hospital, Yangsan, South Korea. 4Department of Pediatrics, Kosin University Gospel Hospital, Busan, South Korea. 5Department of Pediatrics, Inje University Busan Paik Hospital, Busan, South Korea. 6Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, South Korea. 7Department of Pediatrics, Dong-A University Hospital, Busan, South Korea. 8Department of Pediatrics, Ilsin Christian Hospital, Busan, South Korea. 9Department of Pediatrics, Mirae Children’s Hospital, Busan, South Korea. 10Department of Pediatrics, Haeundae Bumin Hospital, Busan, South Korea
Background: This study aim ed to compare the response to growth hormone (GH) therapy according to the presence of GH deficiency (GHD) in short-stature children born small for gestational age (SGA) in Korea and to present appropriate GH dose criteria.
Methods: We evaluated 27 children born SGA with short stature and GHD (GHD group) and 23 without GHD (non-GHD group) registered in the LG Growth Study. Growth responses and changes in GH dose over a 2-year GH therapy period were compared, and the factors affecting growth response were investigated.
Results: The standard deviation scores (SDSs) for baseline weight and body mass index (BMI) were significantly lower in boys with GHD than in boys without GHD. The SDS for insulin-like growth factor-1 (IGF-1) was lower among boys with GHD than among boys without GHD, while the SDS for insulin-like growth factor-binding protein-3 (IGFBP-3) was higher among girls with GHD than among girls without GHD; however, there was no significant difference in the comparison between all children with GHD and without. Regardless of the presence of GHD, the difference between chronological age and bone age decreased annually. Notably, there was significantly rapid bone age progression among patients without GHD. The findings showed differences in GH dose according to GHD starting from the 2nd year of therapy, with the non-GHD group receiving a significantly higher dose. Regarding the factors affecting growth response, younger age, bone age, higher height SDS, BMI SDS, and mid-parental height SDS were correlated with increased growth velocity. While change in height SDS and change in growth velocity increased with higher GH dose, the assessment between the GHD and non-GHD groups showed no significant differences.
Conclusion: GHD is rare among children born SGA. Nonetheless, if there are any signs of decreased growth velocity or hypopituitarism, the presence of GHD should be assessed before GH therapy, and personalized therapy based on the results is required.