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Growth hormone treatment in patients with neurosecretory dysfunction
P Rochiccioli1, E Dechaux, M T Tauber
1Service de Pédiatrie (Unité d'Endocrinologie), CHU Rangueil, Toulouse, France.
Insights
Biosynthetic human growth hormone (hGH) treatment effectively improved growth velocity in children with neurosecretory dysfunction. These results are comparable to those seen in children with total growth hormone deficiency.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Neurosecretory Dysfunction
Background:
- Neurosecretory dysfunction (NSD) is characterized by impaired 24-hour GH secretion.
- Children with NSD exhibit significant growth retardation.
Purpose of the Study:
- To evaluate the efficacy of biosynthetic human growth hormone (hGH) in treating children with NSD.
- To compare treatment outcomes in NSD with those in classic GH deficiency.
Main Methods:
- Twenty-four children with NSD were treated with biosynthetic hGH (0.42 IU/kg/week).
- Growth velocity was measured before and after treatment.
- Secretory profiles were analyzed to categorize response patterns.
Main Results:
- hGH treatment increased mean growth velocity from 4.9 cm/year to 6.8 cm/year.
- Responders (n=14) achieved an 8.1 cm/year growth velocity, while poor responders (n=10) achieved 4.9 cm/year.
- Treatment outcomes were comparable to those in children with total GH deficiency.
Conclusions:
- Biosynthetic hGH is an effective treatment for growth retardation in children with NSD.
- Treatment efficacy varies, with distinct responder and non-responder groups identified.
- hGH therapy for NSD yields results comparable to classic GH deficiency treatment.
Abstract:
Twenty-four children (14 boys and 10 girls) with neurosecretory dysfunction, defined by a response greater than 10 ng/ml to two pharmacological tests, and 24-hour GH secretion less than 3 ng/ml/min, were treated with biosynthetic hGH. Mean age was 10 years 8 months +/- 3 years 6 months. Growth retardation was -2.8 +/- 0.8 SD. Eighteen children were prepubertal and six pubertal (P2). Mean peaks in two pharmacological stimulation tests were 25.8 +/- 14.8 and 20.8 +/- 11.5 ng/ml. Somatomedin C/insulin-like growth factor I level was 0.8 +/- 0.6 IU/ml in the prepubertal children. Twenty-four-hour integrated concentration of GH was low, at 2.2 +/- 0.5 ng/ml/min. Analysis of secretory profiles showed 3 types: (1) hyperpulsatile profile with numerous peaks of low amplitude, (2) flat profile, (3) profile with an isolated peak greater than 10 ng/ml. Treatment with hGH (0.42 IU/kg/week) resulted in an increase in growth velocity from 4.9 +/- 1.2 to 6.8 +/- 2.2 cm/year. These results are comparable to those of a group with total GH deficiency receiving the same dose. Analysis of the results showed a group of good responders (n = 14, growth velocity: 8.1 cm/year) and a group of poor responders (n = 10, growth velocity: 4.9 cm/year). Thus, treatment of neurosecretory dysfunction with hGH gives results comparable to those obtained in classic GH secretory dysfunction.