Final Height in Children with Idiopathic Growth Hormone Deficiency treated with Growth Hormone: Albanian experience

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy
• Human Growth and Development

Background:

• Idiopathic growth hormone deficiency (IGHD) in children leads to significantly reduced adult height.
• Recombinant human growth hormone (rhGH) is a standard treatment, but its long-term efficacy and prognostic factors require continued evaluation.
• Understanding factors influencing final height is crucial for optimizing treatment strategies in IGHD patients.

Purpose of the Study:

• To assess the effectiveness of rhGH in achieving adult height in children with IGHD.
• To identify prognostic factors that influence final height outcomes in this population.
• To evaluate the correlation between treatment parameters and final height attainment.

Main Methods:

• An observational follow-up study utilizing a population-based registry of Albanian children with IGHD.
• Data collected on children who attained final height after starting rhGH treatment between 2001 and 2011.
• Analysis of annual height changes, adult height z-scores, and influencing factors like treatment dose, duration, and pubertal status.

Main Results:

• Eighty-three patients (55%) achieved final adult height, with an average height gain of 2.40±1.13 z-scores over 4.0±2.0 years.
• The mean adult height was -1.98±1.12 z-score, with 61.5% reaching within their target height range.
• Regression towards the mean, patient characteristics, and delayed puberty were significant contributors to height gain variation.

Conclusions:

• rhGH therapy enables children with IGHD to achieve near their genetic height potential.
• Despite late treatment initiation, significant height gains were observed, with a majority attaining target height.
• Final height demonstrated a strong correlation with predicted height, baseline HAZ score, pubertal changes, treatment duration, and initial pubertal stage.