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Children with normal-variant short stature: treatment with human growth hormone for six months
Insights
Short stature in children can be predicted by response to human growth hormone (hGH) therapy. Children with a positive anabolic and growth response to short-term hGH treatment are likely to benefit from long-term therapy.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Children with normal-variant short stature exhibit varied responses to human growth hormone (hGH).
- Classifying these children into subgroups based on hGH response aids in predicting treatment efficacy.
Purpose of the Study:
- To evaluate the relationship between short-term anabolic and growth responses to hGH and long-term growth outcomes.
- To identify a rapid method for predicting which children with short stature will benefit from hGH therapy.
Main Methods:
- Four to six children (ages 8-11) from each of four predefined subgroups were monitored.
- Growth rate and plasma somatomedin C levels were measured before, during, and after six months of daily hGH injections (0.08 unit/kg/day).
Main Results:
- Children in Subgroups 3 and 4 showed subnormal somatomedin C levels pre-treatment, which normalized with hGH, accompanied by a fivefold increase in growth rate.
- Children in Subgroups 1 and 2 had normal pre-treatment somatomedin C levels and showed minimal response to hGH in terms of somatomedin levels or growth rate.
- The somatomedin response in responsive subgroups (3 and 4) was evident by day 10 of treatment.
Conclusions:
- Short-term assessment of anabolic and somatomedin C response to hGH can rapidly identify children who will benefit from long-term therapy.
- This diagnostic approach allows for personalized treatment strategies in pediatric short stature.
Abstract:
Children with normal-variant short stature can be classified into four subgroups by measuring their anabolic and growth reactions to a 10-day course of human growth hormone. In Subgroup 1 there is no anabolic or growth reaction; in Subgroup 2 there is a weak anabolic reaction but no growth; Subgroups 3 and 4 have both reactions but Subgroup 4 is more responsive than Subgroup 3. We monitored growth rate and plasma immunoreactive somatomedin C concentrations in four to six children from each subgroup (age range, eight to 11 years) before, during, and after six months of injections of growth hormone (0.08 unit per kilogram of body weight per day). In children in Subgroups 3 and 4, the average somatomedin C level, which was subnormal before treatment, was restored to normal. Simultaneously, the average growth rate accelerated fivefold. In children in Subgroups 1 and 2, whose average pretreatment somatomedin C was normal, growth hormone had little effect on somatomedin level of growth rate. The somatomedin response in Subgroups 3 and 4 was apparent by the 10th day of treatment. This response provides a rapid method for identifying affected children who will benefit from longterm administration of human growth hormone.