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Final height after growth hormone therapy in non-growth-hormone-deficient children with short stature
1Servizio di Endocrinologia Pediatrica, Ospedale Microcitemico, Cagliari, Italy.
Insights
Growth hormone (GH) treatment for short children without GH deficiency increased growth velocity initially but did not significantly alter final height compared to target height. The study suggests GH does not generally increase final height beyond genetic potential in these children.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Short stature in children without growth hormone deficiency is a clinical concern.
- Growth hormone (GH) therapy is used, but its efficacy in non-GH-deficient short children requires further investigation.
- Understanding the long-term effects of GH on final height is crucial for treatment guidelines.
Purpose of the Study:
- To evaluate the long-term effects of growth hormone (GH) treatment on final height in prepubertal children with short stature but without GH deficiency.
- To compare the efficacy of two different GH dosages (0.5 U/kg/week vs. 1.0 U/kg/week) on growth outcomes.
- To assess the impact of GH treatment on puberty onset and skeletal maturation.
Main Methods:
- A cohort of 15 prepubertal short children (non-GH-deficient) received GH treatment for 4-10 years.
- Patients were divided into two groups based on GH dosage: 0.5 U/kg/week (n=7) and 1.0 U/kg/week (n=8).
- Linear growth velocity, puberty onset, skeletal maturation, and final height standard deviation scores (SDS) were monitored.
Main Results:
- GH treatment significantly increased linear growth velocity in the first year for both dosage groups.
- The enhanced growth velocity was sustained for approximately 4 years before declining to pretreatment levels in most subjects.
- Final height SDS was significantly higher than baseline height SDS but did not differ from predicted adult height or target height SDS. Puberty onset was not advanced, but skeletal maturation tended to accelerate.
Conclusions:
- Growth hormone treatment in short, non-GH-deficient children leads to an initial increase in growth velocity.
- GH therapy does not appear to increase final height beyond the genetically determined target height in this population.
- Long-term final height is significantly correlated with target height, emphasizing the role of genetic potential in determining adult stature.
Abstract:
We report the effect of growth hormone (GH) treatment for 4 to 10 years in 15 prepubertal non-GH-deficient short children (10 boys, 5 girls, aged 7.4 to 13.2 years). In 7 patients, GH was administered at a dosage of 0.5 U/kg per week (group 1: 4 boys, 3 girls) and in 8 patients (group 2: 6 boys, 2 girls) at a dosage of 1.0 U/kg per week. After the first year, mean linear growth velocity had significantly increased in both groups. The increase in growth velocity was sustained during the first 4 years and then declined to pretreatment values in the majority of subjects. Treatment with GH did not induce an earlier onset of puberty, but there was a tendency toward faster skeletal maturation. The mean final height standard deviation score (SDS) was similar in the two groups and was significantly higher than the height SDS for chronologic age before treatment, but it did not differ from mean pretreatment predicted adult height SDS nor from mean target height SDS in both groups. Final height was significantly correlated with target height in both groups. These preliminary observations indicate that GH treatment does not generally increase final height over target height in short non-GH-deficient children.