Growth hormone retesting during puberty: a cohort study.

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy

Background:

• Growth hormone (GH) deficiency (GHD) diagnosis and treatment in children requires careful monitoring.
• Assessing GH secretion during puberty is crucial for treatment decisions.

Purpose of the Study:

• To determine the frequency of normalized GH secretion in adolescents with prior GHD.
• To identify predictors of GH sufficiency during puberty.
• To evaluate the impact of treatment discontinuation and retesting on final height.

Main Methods:

• Clinical analysis of 80 children with idiopathic GHD treated for at least 2 years.
• Discontinuation of GH therapy at mid-puberty, followed by retesting (arginine test) after 12 weeks.
• Definitive discontinuation of therapy if GH peak was ≥8 μg/L; otherwise, therapy was restarted.

Main Results:

• GH therapy was discontinued in 55% and restarted in 45% of participants.
• No significant differences in definitive height or height gain were observed between groups.
• Insulin-like growth factor-1 (IGF-1) levels after 1 year of GH treatment were the sole predictor of GH sufficiency at mid-puberty.

Conclusions:

• Retesting GH secretion at mid-puberty is a valuable strategy.
• This approach can minimize treatment duration, potential side effects, and healthcare costs.
• Pubertal retesting ensures optimal growth potential and final height achievement without compromising outcomes.