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Use of Growth Hormone in children with short stature and normal Growth Hormone secretion: a growing problem

H J Guyda1

  • 1Montreal Children's Hospital, McGill University, Quebec, Canada.

Trends in Endocrinology and Metabolism: TEM
|October 1, 1994
PubMed

Insights

Growth hormone (GH) therapy for children with short stature shows minimal impact on final height. Most patients experience less than 1 cm/year gain, with many reporting no significant benefit from GH treatment.

Area of Science:

  • Pediatric Endocrinology
  • Growth and Development
  • Medical Ethics

Background:

  • Short stature in children presents complex ethical, economic, psychologic, and social considerations.
  • Growth hormone (GH) therapy is a potential intervention, but its efficacy in achieving significant final height in otherwise healthy short children is debated.

Purpose of the Study:

  • To evaluate the ethical, economic, psychologic, social, and growth attainment outcomes of GH therapy in normal children with short stature.
  • To determine the actual benefit of GH treatment on final height in non-pathological short stature.

Main Methods:

  • Review of ethical, economic, psychologic, and social issues.
  • Analysis of data from an international survey of 99 normal short children treated with GH for at least 3 years.
  • Assessment of growth velocity acceleration and final height attainment.

Main Results:

  • GH treatment can accelerate growth velocity in some short children.
  • Limited data indicate no significant benefit in final height attainment, with a mean gain of <1 cm/year.
  • A significant portion (40%) of patients reported no benefit, and only one-third considered the results very good or good.

Conclusions:

  • GH therapy is unlikely to dramatically increase final height in children with normal short stature.
  • Current evidence does not support the use of GH for treating normal short stature outside of controlled clinical trials.
  • Careful consideration of limited benefits versus potential risks is crucial for this patient group.

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