ESPE2024 Poster Category 2 Late Breaking (107 abstracts)
Predictive factors for growth hormone response in the first year of treatment among children with growth hormone deficiency in Algeria
Sakina Kherra 1,2 , Adel Djermane 3 , Yasmine Ouarezki 3 , Fadila Bouferoua 4 , Sihem Bellouti 1 , Latifa Sifour 5 , Hassiba Sahli 1 , Noureddine Boutaghane 6 , Meriem Bensalah 7 , Kahina Mohamedi 8 , Amina Chikh 1 , Belaid Ait Abdelkadder 9 , Asmahane Ladjouze 5 , Regis Coutant 10 & Zoulikha Zeroual 11
1CHU Hussein Dey, Algiers, Algeria. 2Pediatric Unit "A", Algiers, Algeria. 3Hassan Badi Hospital, Algiers, Algeria. 4CHU Beni Messous, Algiers, Algeria. 5CHU Lamine Debaghine, Algiers, Algeria. 6CHU Nafissa Hamoud Neonate Unite, Algiers, Algeria. 7CHU Ain Nadja, Algiers, Algeria. 8Ain Taya Hospital, Algiers, Algeria. 9CHU Mustapha, Algiers, Algeria. 10CHU Angers, Angers, France. 11CHU Nafissa Hamoud, Algiers, Algeria
Introduction: Several predictive factors of response to rGH have already been described in the literature such as age and height at the beginning of treatment, rGH dose and parental height status. However, few data exist on the predictive value of pre-therapeutic data on the response to rGH.
The main objective of the study: is to identify predictive factors of the rGH response in children with GHD, with a particular interest in the clinical and biological data before and at the early initiation of treatment.
Material and Methods: This prospective analytical study involving children treated with rGH for GHD. A longitudinal statistical approach was used, with calculation of statural gain as increment in height standard deviation score (ΔHTSDS) during the first year of treatment in relation to clinical data (age, sex, body mass index), paraclinical information (bone age, IGF-1, IGF1 generation test, peak GH after stimulation, topographical aspect of the pituitary gland at magnetic resonance imaging), and therapeutic factors (modalities of GH treatment). First-year response to rGH was analysed using, univariate, bivariate and multivariate regression analysis.
Results: We collected data on 144 Algerian children with GHD who had received rGH. The mean (SD) age at diagnosis was 8.60 ± 4.12 years, while the mean age at initiation of rGH was 8.88 ± 4.08 years. The response to rGH was negatively correlated with the initial height before treatment, (P = 0,016, OdRc: 5,78, IC : 0,211 – 0,853) but positively correlated to the difference in bone age compared to chronological age, (OdrC = 5.47, CI: 1.08 - 2.54, P = 0.019), positively correlated to the rate of IGF-1 (OdrC = 4.63 CI: 1.042 - 2.41; P = 0.030) and to the statural gain at 03 months of rGH (OdrC = 13.02, CI: 1.38 - 2.98; P = 0.000). A significantly positive relationship was found between the overall statural gain at the end of the first year of treatment and the pituitary aspect in MRI in bivariate analysis (P = 0.025), but not in multivariate logistic regression. No significant association with initial age, anthropometric data at birth, family target size and depth or type of GHD was found.
Conclusion: These results can help to select GHD patients who are thought to be better or poor responders to rGH treatment, and offer them appropriate and adequate management, while identifying predictive factors including; initial Height, BA/CA gap, Δ IGF1SDS, and the gain in stature in SD at 3 months.
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