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Published on: February 2, 2017
Factors influencing growth in children with growth hormone deficiency - a case-control study
NIkhil Lohiya1, Hemchand Krishna Prasad2, Kannan Narayanasamy1
1Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt Ltd, India.
Insights
Growth hormone therapy significantly improves height in South Indian children with growth hormone deficiency (GHD). Optimal treatment duration is 15 months, with early diagnosis and specific factors influencing response.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Child Development
Background:
- Growth hormone deficiency (GHD) affects children's growth.
- Understanding treatment response in South Indian children is crucial.
Purpose of the Study:
- Assess GHD children's response to growth hormone (GH) therapy.
- Determine optimal GH therapy duration for catch-up growth.
- Identify factors influencing treatment outcomes in South Indian children.
Main Methods:
- Case-control study at a pediatric endocrine unit.
- Compared children with GHD on GH therapy (cases) to untreated controls.
- Collected clinical, biochemical, and radiological data at baseline and follow-up.
Main Results:
- GH therapy group showed significant height increase compared to controls.
- Growth velocity was significantly higher in the GH-treated group.
- Therapy duration, ectopic posterior pituitary, and bone age to chronological age ratio impacted growth velocity.
Conclusions:
- Early diagnosis, pre-pubertal status, delayed bone age, and ectopic posterior pituitary predict better GH therapy response.
- At least 15 months of GH therapy is recommended for achieving target height SDS.
Introduction:
To assess the response of South Indian children with growth hormone deficiency (GHD) to growth hormone therapy, optimal duration of therapy for good catch up, and factors determining the response of our children to growth hormone therapy.
Material And Methods:
We conducted a case control study at a paediatric endocrine unit of a tertiary paediatric hospital. Children diagnosed with growth hormone deficiency were initiated on GH (cases) or followed up without GH therapy (controls). Detailed clinical, biochemical, radiological, and treatment parameters were recorded at baseline and follow-up. Data were analysed using IBM SPSS version 21.
Results:
We enrolled 23 subjects in group I (cases who received GH) and group II (controls with untreated children), and both the groups were comparable at baseline. Group I (-4.12 ±1.7 to -2.81 ±1.52) had significant height increase on follow-up after GH therapy compared to group II (-3.55 ±1.7 to -3.51 ±1.52) (p > 0.05). Growth velocity in group I (13.25 ±5.6 cm/year, SD score 4.55 ±5.42) was significantly higher compared to group II (3.4 ±1.8 cm/year, SD score -1.62 ±2.38). Duration of growth hormone therapy, presence of ectopic posterior pituitary, and BA: CA ratio independently impacted the growth velocity SD scores. Kaplan Meier analysis curve showed 15 months of GH therapy was needed to attain a height within ±2 SD of the target height.
Conclusions:
Early diagnosis, pre-pubertal status, delayed bone age, and presence of ectopic posterior pituitary on MRI are determinants of a better response. Growth hormone must be administered for at least 15 months for catch up height SDs within target height SD range.
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