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Effects of 3 years of growth hormone therapy in short normal children
P C Hindmarsh1, P J Pringle, L Di Silvio
1Endocrine Unit, Middlesex Hospital, London, UK.
Insights
Growth hormone (GH) therapy significantly boosts height velocity and predicted final height in short children. Initial insulin increases normalize, showing GH is safe for carbohydrate metabolism during treatment.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Metabolic Studies
Background:
- Short stature in children requires effective treatment strategies.
- Growth hormone (GH) is a key regulator of childhood growth.
- Understanding GH's long-term effects on growth and metabolism is crucial.
Purpose of the Study:
- To evaluate the 3-year effects of growth hormone (GH) treatment on growth rate, predicted height, carbohydrate and metabolic status, and thyroid function.
- To assess the impact of varying GH dosage on growth deceleration.
- To monitor glucose homeostasis and insulin response during GH therapy.
Main Methods:
- Study included 16 short prepubertal children with normal pretreatment growth rates.
- Growth hormone (GH) treatment administered for 3 years.
- Evaluated height velocity, predicted final height, glucose homeostasis, serum insulin, and thyroid function.
Main Results:
- Height velocity SDS significantly increased in the first year and remained positive.
- Predicted final height increased by 6.8 cm in boys and 4.2 cm in girls after 3 years.
- Increased GH dosage reduced growth deceleration; glucose homeostasis was maintained with transient insulin elevation.
Conclusions:
- Three years of GH treatment effectively improves growth rate and final height prognosis in short children.
- GH therapy demonstrates a favorable safety profile regarding carbohydrate and metabolic status.
- Optimized GH dosing can mitigate growth deceleration and enhance treatment outcomes.
Abstract:
The effect of 3 years of growth hormone (GH) treatment on growth rate, predicted height, carbohydrate and metabolic status, and thyroid function was studied in 16 short prepubertal children growing with a normal pretreatment growth rate. The height velocity SDS increased from a pretreatment value of -0.44 +/- 0.33 (mean +/- SD) to a value of +2.20 +/- 1.03 during the first year of treatment. It was maintained at a value above zero over the subsequent 2 years. By the end of the third year of treatment, the predicted final height had increased by 6.8 cm in the boys and by 4.2 cm in the girls (p less than 0.001 and p less than 0.01, respectively). Increasing the dose of GH on a body surface area basis reduced the deceleration of growth observed during the second year of treatment, leading to an improvement in height prognosis over that year. Glucose homoeostasis was achieved initially at the expense of an elevation in fasting serum insulin concentration, but this had returned to pretreatment values by the end of the second year of therapy.