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Therapy in short children with subnormal integrated concentrations of growth hormone
S A Chalew1, S Raiti, K M Armour
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore 21201.
Insights
Growth hormone (GH) therapy significantly increased growth rates in children with subnormal GH levels. However, growth slowed after therapy cessation, indicating a need for continued treatment for sustained growth.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
Background:
- Children with normal GH response but subnormal integrated GH concentrations often exhibit poor growth.
- Assessing the impact of growth hormone (GH) therapy in this specific patient group is crucial.
Purpose of the Study:
- To evaluate the efficacy of GH therapy on posttreatment growth in children with specific GH deficiency patterns.
- To determine the long-term effects of GH therapy cessation.
Main Methods:
- Eleven children with poor growth received GH therapy (0.1 U/kg, three times/week).
- Growth rates were measured before, during, and after treatment.
- Subsequent growth patterns after therapy cessation were monitored.
Main Results:
- Mean growth rate increased from 3.3 cm/y to 6.5 cm/y during treatment.
- Five patients experienced a decline in growth rate below 4.5 cm/y after stopping GH therapy.
- Three of these patients resumed therapy and showed increased growth velocity (8.0 cm/y).
- Prepubertal patients without therapy showed a decline in growth velocity to 3.8 cm/y over 12 months.
Conclusions:
- Sustained growth in children with subnormal integrated GH concentrations depends on continuous GH replacement therapy.
- GH therapy is effective in improving growth velocity in this population.
- Growth velocity declines after therapy cessation, particularly in prepubertal children.
Abstract:
We evaluated the effect of growth hormone (GH) therapy on the posttreatment growth of 11 poorly growing children who had normal GH response to provocative stimuli but subnormal integrated concentrations of GH. Patients received 0.1 U/kg of GH three times per week. Their mean (+/- SD) growth rate increased from 3.3 +/- 1.0 cm/y before treatment to 6.5 +/- 1.4 cm/y after eight months of treatment. The growth rates of five patients declined to below 4.5 cm/y four months after treatment. Three of these patients resumed GH therapy and again responded with increased growth velocity (8.0 +/- 1.2 cm/y). After therapy, the growth rate of five remaining patients continued to be greater than 4.5 cm/y (6.8 +/- 1.4 cm/y). Two of these patients had entered puberty and their posttreatment growth rate might have been due to a pubertal growth spurt. The three prepubertal patients in this group had a gradual decline in growth velocity to 3.8 +/- 1.0 cm/y by the end of 12 posttreatment months. We conclude that maintenance of normal growth in patients with this pattern of GH deficiency is dependent on GH replacement therapy.