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[Effects of human growth hormone on very short children with intermediate responses to somatotropic stimulation
Insights
Human growth hormone (hGH) treatment effectively accelerated growth in children with growth retardation, particularly those starting treatment at puberty. Stimulation test results did not predict treatment success in these cases.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Clinical Research
Background:
- Growth retardation affects children with significant deviations in height and insufficient growth velocity.
- Pharmacologic somatotropic stimulation tests assess pituitary function but can yield discordant responses in some children.
- Partial growth hormone (GH) deficiency is a consideration in children with suboptimal responses to stimulation tests.
Purpose of the Study:
- To evaluate the efficacy of human growth hormone (hGH) treatment in children with growth retardation and discordant stimulation test results.
- To determine if GH stimulation test levels correlate with clinical outcomes in treated children.
- To explore the concept of partial GH deficiency and guide treatment decisions for short children.
Main Methods:
- A cohort of 29 patients (aged 2-16 years) with growth retardation (2.2-6 SD) and insufficient growth velocity were treated with hGH.
- Patients had previously shown discordant responses (<6 ng/ml or >7 ng/ml) on repeated somatotropic stimulation tests.
- Growth response was assessed, and correlation with GH stimulation levels was analyzed.
Main Results:
- Significant growth acceleration was observed in 10 of 16 pre-pubertal patients.
- All 13 patients treated at the onset of puberty experienced substantial growth acceleration.
- No correlation was found between GH levels during stimulation tests and the clinical effectiveness of hGH treatment.
Conclusions:
- hGH treatment can be beneficial for children with growth retardation and specific patterns of discordant GH stimulation test results.
- Treatment appears particularly effective when initiated at the beginning of puberty.
- The study suggests a trial of hGH therapy for very short children with low or dissociated responses to repeated pituitary stimulation tests, irrespective of test levels.
Abstract:
The effects of treatment with human growth hormone (hGH) were studied in 29 patients aged 2 to 16 years with growth retardation between 2.2 and 6 standard deviations and insufficient growth velocity in whom repeated pharmacologic somatotropic stimulation tests had shown discordant responses either above 7 ng/ml, or lower than 6 ng/ml. An important acceleration of growth was obtained in 10 of 16 patients before puberty and in all the 13 cases treated at the beginning of puberty. No correlation was observed between the GH levels observed during the stimulation tests and the clinical results of treatment. These data lead to discuss partial GH deficiency and to propose a trial of treatment in very short children with low and/or dissociated responses to repeated tests of pituitary somatotropic secretion.