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Change in total body water as a predictive tool for growth hormone treatment response

Manon A B Ernst1, Michelle Y G Simons, Angèle J G M Gerver

  • 1Department of Paediatrics, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.

Hormone Research in Paediatrics
|July 21, 2012
PubMed

Insights

Short-term changes in total body water (TBW) can predict growth hormone therapy effectiveness. This helps identify adequate responders in growth hormone deficiency (GHD) and small for gestational age (SGA) children.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Body Composition Analysis

Background:

  • Growth hormone deficiency (GHD) and small for gestational age (SGA) are common conditions in pediatric endocrinology.
  • Predicting the long-term growth response to recombinant human growth hormone (rhGH) therapy is crucial for optimizing treatment outcomes.
  • Short-term changes in body composition may offer early indicators of treatment efficacy.

Purpose of the Study:

  • To evaluate if short-term changes in body composition predict the 1-year growth response to rhGH therapy.
  • To assess the predictive value of total body water (TBW) changes in children with GHD and SGA.

Main Methods:

  • A cohort of 88 GHD and 99 SGA children receiving rhGH therapy was studied.
  • Total body water (TBW) and height were measured at baseline and during treatment.
  • Patients were categorized into adequate and inadequate responders after 1 year of therapy.

Main Results:

  • In GHD children, TBW changes showed 87% sensitivity and 58% specificity, with a 73% positive predictive value.
  • In SGA children, TBW changes demonstrated 53% sensitivity and 83% specificity, with a 90% positive predictive value.
  • TBW changes accurately predicted outcomes in 75% of GHD children and were useful in SGA children above a 0.7 L/m² threshold.

Conclusions:

  • Short-term changes in TBW are a valuable tool for predicting rhGH therapy response in GHD children.
  • For SGA children, TBW changes are predictive only when exceeding a specific cut-off value (0.7 L/m²).
  • Body composition monitoring offers a potential method for early assessment of rhGH therapy effectiveness in pediatric populations.
Abstract

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