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Growth hormone deficit. Does the first year of treatment influence adult height?
María José Sánchez Malo1, Juan Hidalgo Sanz2, Rebeca Hernández Abadía2
1Servicio de Pediatría, Hospital Reina Sofía, Tudela, Navarra, Spain.
Insights
Early response to growth hormone treatment in children with short stature predicts better final height outcomes. A severe deficit also indicates a more favorable long-term response to therapy.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Short Stature Treatment
Background:
- Short stature is a common reason for pediatric endocrinology consultations.
- Growth hormone (GH) therapy is sometimes required for children with short stature.
Purpose of the Study:
- To investigate the correlation between early treatment response and final height outcomes in children with idiopathic growth hormone deficiency.
- To determine if the type of growth hormone deficiency influences treatment response.
Main Methods:
- A longitudinal, retrospective observational study of 139 patients treated for idiopathic growth hormone deficiency.
- Defined criteria for good early response in the first year of treatment (e.g., growth rate increase ≥3 cm/year, growth rate ≥1 SD).
- Analyzed the Index of Responsiveness in the first and second years and correlated with final adult height outcomes.
Main Results:
- Growth hormone treatment resulted in a modest gain in adult height relative to genetic height (0.06 ± 0.7 SD).
- Patients showing good early response criteria in the first year achieved significantly better final height outcomes.
- A severe growth hormone deficit was also associated with a better long-term treatment response (p=0.04).
- The Index of Responsiveness in the first year correlated with better final response (r=0.249, p=0.003), a correlation maintained in the second year (r=0.294, p=0.01).
Conclusions:
- Growth hormone treatment effectively increases height towards the genetic target.
- Early treatment response within the first year and the severity of the deficit are key predictors of successful long-term growth outcomes.
- The criteria for defining a 'good responder' can influence the observed percentage of patients achieving optimal results.
Introduction:
Short stature is the most frequent reason for Pediatric Endocrinology consultations and sometimes requires treatment with growth hormone.
Objective:
The possible correlation of a good response to any early response factor with a better final response was studied, and also whether there was a difference in response to treatment according to the type of deficit.
Patients And Methods:
This was a longitudinal, retrospective and observational study of 139 patients treated for idiopathic growth hormone deficiency up to adult height. There were good response criteria in the first year of treatment: a) an increase in growth rate ≥3 cm/year, b) a growth rate ≥1 standard deviation (SD), c) an increase in height ≥0.5 SD, d) an increase in height ≥0.3 SD. Study of the Index of Responsiveness to treatment in the first and second year. Final response variables: adult height with respect to target height, adult height with respect to initial growth prediction and adult height with respect to initial height at the start of treatment. The possible correlation of a good response to any of the early response factors with a better final response to treatment was studied, and also whether there was a difference in the response to treatment according to the type of deficit.
Results:
The treatment produced a gain in adult height with respect to genetic height of 0.06 ± 0.7 SD. Patients considered good responders in the first year of treatment presented a better final response (growth rate ≥3 cm: p = 0.000, growth rate ≥1 SD: p = 0.008, height gain ≥0.5 SD: p = 0.007, height gain ≥0.3 SD: p = 0.006), as well as patients with a severe deficit (p = 0.04). The index of responsiveness to treatment during the first year was associated with a better final response (r = 0.249, p = 0.003), with this correlation being maintained in the second year (r = 0.294, p = 0.01).
Conclusions:
Growth hormone treatment increased height in the genetic target. The percentage of good responders varied depending on the criteria used. The response in the first year of treatment and a severe deficit were determining factors for achieving a good long-term response.
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