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Published on: February 2, 2017
Does excessive body mass affect the rhGH therapy outcomes in GHD children?
Tomasz Maroszczuk1, Jan Maciej Kapała1, Aleksandra Sitarz1
1Department of Clinical Paediatrics, Faculty of Medical Sciences, University of Warmia and Mazury, Poland.
Insights
Excess body weight negatively impacts recombinant human growth hormone (rhGH) therapy effectiveness in children with growth hormone deficiency (GHD). Overweight children show poorer long-term height outcomes compared to normal-weight peers.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Recombinant human growth hormone (rhGH) has been used for 35 years to treat children with growth hormone deficiency (GHD).
- Individualized treatment approaches are crucial due to variable patient responses to rhGH therapy.
- Excessive body weight is a known factor influencing rhGH treatment efficacy.
Purpose of the Study:
- To investigate the impact of excessive body mass on the effectiveness of rhGH therapy in children with GHD.
Main Methods:
- 165 children with isolated GHD (mean age 10.72 years) were treated with rhGH for at least one year.
- Participants were stratified into three groups based on BMI standard deviation score (SDS).
- Data collected included bone age, height, weight, IGF-1 levels, and rhGH dose over a 10-year period.
Main Results:
- Initial height SDS increase in the first year was comparable between normal and excessive body weight groups (0.52 SD vs. 0.60 SD).
- Long-term height velocity over 5 years was significantly lower in the excessive body weight group (0.32 SD/year) compared to the normal-weight group (0.44 SD/year).
Conclusions:
- Excess body weight significantly impacts rhGH therapy outcomes in children with GHD.
- While initial height gains may be similar, long-term results are substantially worse for overweight or obese children.
- This highlights the need to consider body mass index in treatment strategies for GHD.
Introduction:
For 35 years, recombinant human growth hormone (rhGH) has been successfully used worldwide to treat children with short stature related to growth hormone deficiency (GHD). Growth hormone therapy requires an individual approach to the patient due to varying responses to the treatment. Excessive body weight is one of the factors influencing the response.
Aim Of The Study:
To evaluate the impact of excessive body mass on rhGH therapy effectiveness in GHD children.
Material And Methods:
165 short-statured children with isolated GHD (mean age 10.72 ±3.33 years), treated with rhGH for at least one year (mean follow-up 4.32 ±1.80 years), were separated into 3 groups based on their BMI standard deviation score (SDS). Bone age, height, weight, insulin-like growth factor 1 level, and rhGH dose were obtained up to 10 years with one-year intervals.
Results:
The mean change in height SDS in the first year was 0.52 ±0.41 SD and 0.60 ±0.32 SD for normal and excessive body weight children, respectively. The mean height velocity, based on the height SDS measured over the consecutive 5 years, was 0.44±0.25 SD/year for the normal-weight group and 0.32 ±0.24 SD/year for the excessive body weight group (p < 0.1).
Conclusions:
Excess body weight has a significant impact on rhGH therapy outcomes. This correlates with the height increase in the first year of observation; however, long-term observation has shown that children diagnosed with overweight or obesity achieve significantly worse results compared to their normal-weight peers.
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