The effect of growth hormone treatment on head circumference in growth hormone-deficient children

Area of Science:

• Pediatrics
• Endocrinology
• Growth and Development

Background:

• Children with growth hormone (GH) deficiency often exhibit disproportionately small head circumference (HC) relative to their chronological age.
• Understanding HC growth patterns during GH therapy is crucial for assessing treatment efficacy and long-term outcomes.

Purpose of the Study:

• To retrospectively analyze head circumference (HC) growth in children with GH deficiency undergoing long-term GH therapy.
• To evaluate the impact of GH therapy on HC standard deviation scores (SDS) relative to both chronological age (CA) and height age (HA).

Main Methods:

• Longitudinal data from 54 children with GH deficiency were analyzed, divided into two groups based on height age (HA ≤5 years and HA >5 years).
• Anthropometric measurements, including HC, were expressed as standard deviation scores (SDS) for CA and HA.
• Statistical analysis compared HC SDS changes before and after GH therapy, and by cumulative GH dose quartiles.

Main Results:

• Group 1 (younger HA) showed significant increases in height SDS (p < 0.001) and HC SDS for CA (p < 0.05) during GH therapy.
• Group 2 (older HA) demonstrated significant height SDS improvement (p < 0.001) but no significant change in HC SDS for CA.
• HC SDS for HA remained stable and disproportionately small for CA but normal for HA across both groups, with a trend towards normalization with higher GH doses.

Conclusions:

• GH therapy promotes HC growth towards normalization, especially in younger children with GH deficiency.
• While higher cumulative GH doses are associated with increased HC, the growth remains appropriate for height.
• HC in GH-deficient children is typically small for chronological age but normal for height age, with GH therapy positively influencing this relationship.