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[Use of arginine hydrochloride in non-endocrine growth disorders]
G Saggese1, G Cesaretti, P Ghirri
1Clinica Pediatrica I, Università degli Studi di Pisa.
Insights
Arginine hydrochloride supplementation improved height velocity in short children without other identifiable causes. This treatment showed a significant positive effect on growth, particularly in height age to bone age ratio.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Nutritional Science
Background:
- Idiopathic short stature (ISS) affects children with no identifiable endocrine or systemic causes.
- Assessing growth velocity is crucial for diagnosing and managing short stature.
Purpose of the Study:
- To evaluate the efficacy of arginine hydrochloride supplementation on auxological parameters in short prepubertal children.
- To compare height velocity before and during arginine hydrochloride treatment.
Main Methods:
- A cohort of 60 short prepubertal children (age 4.17-10.5 years) with decreased height velocity was studied.
- A 12-month 'off-treatment' period was compared to a subsequent 12-month 'on-treatment' period with arginine hydrochloride.
- Auxological features, including height and height velocity, were monitored and analyzed using standard deviation scores (SDS).
Main Results:
- Arginine hydrochloride treatment significantly increased height velocity (p < 0.001).
- Height SDS showed a significant improvement during the 'on-treatment' period compared to the 'off-treatment' period.
- The height age/bone age ratio improved significantly with arginine hydrochloride administration (p < 0.01).
Conclusions:
- Arginine hydrochloride is an effective treatment for improving growth velocity in short children with idiopathic short stature.
- Supplementation with arginine hydrochloride positively impacts auxological parameters, including height and height age/bone age ratio.
- Further research may explore long-term effects and optimal dosing strategies.
Abstract:
We have examined a group composed of 60 short prepubertal children (height less than 3 degrees centile; 31 M, 29 F, age from 4.17-10.5 years) with a decreased height velocity (less than 10 degrees centile) and in which endocrine, systemic or specific causes of short stature have been ruled out by the performance of several instrumental or laboratory analyses. Auxological features of a 12-month period (from time -12 to time 0) without any treatment ("off" period) have been compared with an immediately following 12-month period (from time 0 to time +12), during which hydrochloride arginine was administered ("on" period); 2 phials per day in subjects older than 6 years and 1 phial per day in those less old than 6 years. In the absence of the pubertal development, height changed from -1.95 +/- 0.29 (m +/- 1 SD) standard deviation scores (SDS) at time -12 to -2.17 +/- 0.28 SDS at time 0 and -2.24 +/- 0.29 SDS at time +12 with a variation of -0.22 +/- 0.09 SDS in "off" period and of -0.07 +/- 0.14 SDS in "on" period (p less than 0.001) and therefore a difference between the two periods of 0.16 +/- 0.13 SDS. Height age (HA)/chronological age (CA) ratio was 0.74 +/- 0.05, 0.73 +/- 0.04 e 0.73 +/- 0.04, at time -12, 0 and +12, respectively. Height velocity changed from 4.18 +/- 0.47 cm/yr, -1.84 +/- 0.45 SDS for CA and -2.07 +/- 0.41 SDS for bone age (BA) during "off" period to 4.72 +/- 0.74 cm/yr, -1.05 +/- 0.83 SDS for CA and -1.31 +/- 0.77 SDS for BA during "on" period (p less than 0.001) with a variation of 0.53 +/- 0.56 cm/yr, 0.78 +/- 0.65 SDS for CA and 0.77 +/- 0.69 SDS for BA. BA resulted 6.57 +/- 1.55 years at time 0 and 7.34 +/- 1.54 years at time +12; HA/BA ratio changed from 0.86 +/- 0.07 at time 0 to 0.88 +/- 0.07 at time +12 (p less than 0.01) with a ratio between the two values of 1.01 +/- 0.02. Height and height velocity did not result statistically different between males and females or between subjects with delayed BA and those with non-delayed BA, while HA/BA ratio resulted significantly higher in the subjects with non-delayed BA than in those with delayed BA.(ABSTRACT TRUNCATED AT 400 WORDS)