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Final height in patients with idiopathic short stature and high growth hormone responses to stimulation tests

Carlos Eduardo Martinelli1, Soraya Sader Milani, Joana Karin Previato

  • 1Department of Paediatrics, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. cemart@fmrp.usp.br

Hormone Research
|December 1, 2006
PubMed

Insights

Children with idiopathic short stature (ISS) who have high growth hormone (GH) levels during testing may achieve a shorter final height (FH). This suggests potential GH-IGF-I axis insensitivity in these patients.

Area of Science:

  • Pediatric Endocrinology
  • Growth Disorders
  • Hormone Physiology

Background:

  • Idiopathic short stature (ISS) is defined by final height (FH) below -2.0 standard deviation score (SDS) without identifiable causes.
  • Children with ISS may exhibit normal or elevated growth hormone (GH) responses to stimulation tests.
  • The final height outcomes for ISS patients with high stimulated GH levels remain under-investigated.

Purpose of the Study:

  • To investigate the final height (FH) in patients diagnosed with idiopathic short stature (ISS).
  • To analyze the correlation between high peak GH responses during provocation tests and FH in ISS patients.
  • To explore potential GH-IGF-I axis insensitivity in this cohort.

Main Methods:

  • Study included 16 patients with ISS and a GH peak ≥40 mU/l following insulin-induced hypoglycemia.
  • Patients were reassessed at age 19.7 ± 2.5 years for final height (FH) measurement.
  • Serum levels of IGF-I, IGFBP-3, ALS, GHBP, and GH bioactivity were measured.

Main Results:

  • The mean final height (FH) was -3.1 ± 1.0 SDS, significantly lower than target height (TH).
  • Insulin-like growth factor I (IGF-I) levels at FH were within -1.5 to +1.5 SDS in 10 patients and >+1.5 SDS in 6 patients.
  • Levels of IGF binding protein 3, acid-labile subunit, GH binding protein, and GH bioactivity were within normal ranges.

Conclusions:

  • Patients with ISS and high GH levels during stimulation tests may experience a more compromised final height (FH).
  • The observed association suggests a possible degree of GH-IGF-I axis insensitivity in severe ISS cases with peak GH >40 mU/l.
Abstract

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