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Growth Hormone Treatment Response: Associated Factors and Stimulated Growth Hormone Secretion Indices in Prepubertal

Aristeidis Giannakopoulos1, Eleni Kallimani1, Alexandra Efthymiadou1

  • 1Department of Pediatrics, Division of Endocrinology, Medical School, University of Patras, Patras, Greece.

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [And] German Diabetes Association
|January 17, 2025
PubMed

Insights

Age and midparental height are key predictors for growth hormone (GH) treatment response in children with GH deficiency. Maximum GH secretion (GHmax) is the most significant predictor among GH secretory indexes.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Biochemical Markers

Background:

  • Idiopathic growth hormone (GH) deficiency affects prepubertal children, necessitating effective treatment strategies.
  • Growth hormone (GH) replacement therapy is a standard treatment for GH deficiency.
  • Predicting treatment response is crucial for optimizing therapeutic outcomes.

Purpose of the Study:

  • To investigate the correlation between initial clinical and biochemical parameters and growth response in prepubertal children with GH deficiency after one year of GH treatment.
  • To analyze GH secretion dynamics from GH stimulation tests in relation to GH treatment response.
  • To identify the best predictors of recombinant human GH (rhGH) treatment response.

Main Methods:

  • Retrospective analysis of 84 prepubertal children (47 males, 37 females) diagnosed with GH deficiency.
  • Evaluation of GH secretory indexes: GHmax, GH secretion rate, and GH secretion volume.
  • Correlation and regression models to determine predictors of the index of responsiveness (IoR) to rhGH treatment.

Main Results:

  • IoR showed a negative correlation with age (r=-0.607, p<0.01) and positive correlations with the distance from midparental height (MPH) (r=0.466, p<0.01) and pretreatment growth velocity (r=0.247, p<0.05).
  • GHmax demonstrated the strongest association with GH secretion volume (r=0.883, p<0.01).
  • GHmax was the best predictor of IoR (β=-0.514, p<0.001), followed by GH secretion volume (β=-0.47, p<0.001) and GH secretion rate (β=-0.367, p<0.001).

Conclusions:

  • Child's age and the deviation of their height from MPH are significant predictors of GH treatment response in idiopathic GH deficiency.
  • GHmax is a more reliable predictor of GH treatment response than other GH secretory indexes like GHSR and GHSV.
  • Combining clinical and biochemical markers may enhance the pretreatment assessment of rhGH treatment response.
Abstract

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