Different long-term response to growth hormone therapy in small- versus appropriate-for-gestational-age children with...

Area of Science:

• Pediatric Endocrinology
• Growth Disorders
• Hormone Therapy

Background:

• The influence of birth weight on growth hormone (GH) therapy response in GH-deficient (GHD) children requires further clarification.
• This study investigates growth patterns in GHD children based on their birth size relative to gestational age.

Purpose of the Study:

• To evaluate the impact of birth size (small-for-gestational-age vs. appropriate-for-gestational-age) on the response to GH therapy in GHD children.
• To compare growth outcomes over 5 years of GH treatment between SGA-GHD and AGA-GHD children.

Main Methods:

• Longitudinal study tracking height and height velocity annually for 5 years.
• Comparison of growth data between 23 small-for-gestational-age GHD (SGA-GHD) children, 26 appropriate-for-gestational-age GHD (AGA-GHD) children, and 22 non-GH-treated SGA children.

Main Results:

• AGA-GHD children consistently exhibited greater height than SGA groups, with significant increases noted from the fourth year of therapy.
• First-year height velocity was significantly higher in AGA-GHD children (2.67 SDS) compared to SGA-GHD children (1.72 SDS).
• The AGA-GHD group demonstrated the highest proportion of subjects achieving mid-parental height (52.4%) and the most substantial height gain over 5 years.

Conclusions:

• Birth size is a critical determinant of GH therapy response in GHD children within the first 5 years of treatment.
• Pediatric endocrinologists must consider birth size when managing GHD children, particularly those born small-for-gestational-age.