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Dose-dependent effect of growth hormone on final height in children with short stature without growth hormone

Kerstin Albertsson-Wikland1, A Stefan Aronson, Jan Gustafsson

  • 1Göteborg Pediatric Growth Research Center/Växthuset, Department of Pediatrics, The Sahlgrenska Academy at University of Gothenburg, and The Queen Silvia Children's Hospital, Göteborg, Sweden. kerstin.albertsson-wikland@pediat.gu.se

The Journal of Clinical Endocrinology and Metabolism
|August 30, 2008
PubMed

Insights

Growth hormone (GH) therapy significantly increases final height in children with idiopathic short stature (ISS). This study found a dose-dependent response, with higher GH doses yielding greater height gains compared to untreated controls.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Childhood Growth Disorders

Background:

  • The efficacy of growth hormone (GH) therapy in non-GH-deficient short children, particularly those with idiopathic short stature (ISS), remains incompletely defined due to a scarcity of controlled trials reaching final height (FH).

Purpose of the Study:

  • To evaluate the impact of two different GH doses on growth to FH in short children, primarily those with ISS, in comparison to an untreated control group.

Main Methods:

  • A long-term, randomized, multicenter controlled trial was conducted in Sweden.
  • Two doses of GH (Genotropin) were administered (33 or 67 microg/kg/day), with a control group receiving no treatment.
  • Final height standard deviation score (SDS), difference in SDS to midparental height (diff MPHSDS), and height SDS gain were the primary outcome measures.

Main Results:

  • GH therapy over 5.9 years resulted in a significantly improved FH SDS (-1.5 vs. -2.4, P<0.032) and diff MPHSDS (-0.2 vs. -1.0, P<0.001) in the per-protocol population compared to controls.
  • A mean gain in height SDS of 1.3 was observed with GH treatment versus 0.2 in controls (P<0.001), demonstrating a clear dose-response relationship that persisted to FH.
  • GH therapy was found to be safe, with no adverse effects on the timing of puberty onset.

Conclusions:

  • GH treatment significantly enhances final height in children with ISS in a dose-dependent manner.
  • The mean height gain was 1.3 SDS (approximately 8 cm), with individual responses varying widely.
  • These findings support the use of GH therapy for improving final height in children diagnosed with ISS.
Abstract

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