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Catch-up Growth in Prepubertal Children Treated for Juvenile Hypothyroidism and Growth Hormone Deficiency can be

Jan M. Wit1, Theo C. J. Sas2, Michael B. Ranke3

  • 1Leiden University Medical Center, Department of Paediatrics, Leiden, The Netherlands

Journal of Clinical Research in Pediatric Endocrinology
|September 16, 2020
PubMed

Insights

Catch-up growth (CUG) modeling, initially for coeliac disease, effectively describes CUG in children with juvenile hypothyroidism (JHT) and growth hormone deficiency (GHD). This approach helps assess treatment adequacy and impact on growth.

Area of Science:

  • Pediatric Endocrinology
  • Growth and Development
  • Biomathematics

Background:

  • Catch-up growth (CUG) is a critical process in children experiencing growth deficits due to conditions like juvenile hypothyroidism (JHT) and growth hormone deficiency (GHD).
  • Previous modeling of CUG, primarily developed for coeliac disease (CD), provides a framework for understanding growth recovery.
  • Assessing the adequacy and dynamics of CUG is essential for optimizing treatment strategies in pediatric endocrine disorders.

Purpose of the Study:

  • To investigate the applicability of a coeliac disease-based CUG model to children with JHT and GHD.
  • To compare the parameters of CUG in children with JHT and GHD to those with CD.
  • To evaluate the influence of different growth hormone (GH) doses on CUG dynamics.

Main Methods:

  • A monomolecular function was applied to height standard deviation score (HSDS) data adjusted for target height (adjHSDS) in prepubertal children with JHT (n=20) and GHD (n=18).
  • Two models were used: one based on a national height reference with age cut-offs and another using prepubertal reference values without an upper age limit.
  • Statistical comparisons were made between JHT, GHD, and CD groups regarding CUG parameters like rate constant (k) and initial/end adjHSDS.

Main Results:

  • The CUG models were successfully fitted in 83-90% of cases, indicating good applicability.
  • Children with JHT showed lower k and initial adjHSDS compared to CD, but similar end adjHSDS.
  • Children with GHD exhibited similar CUG patterns to JHT, with lower k than CD but comparable initial and end adjHSDS to both CD and JHT. Differences between GH dose subgroups were not statistically significant.

Conclusions:

  • The CUG modeling approach is suitable for assessing growth recovery in prepubertal children with JHT and GHD.
  • The study highlights similarities in CUG shape between JHT and GHD, while CD patients demonstrated a less severe initial deficit and faster CUG.
  • This modeling provides a valuable tool for evaluating the effectiveness of clinical treatments on the speed and magnitude of CUG.
Abstract

Keywords:
Growthcatch-up growthcoeliac diseasegrowth hormone deficiencyhypothyroidism

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