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A partial transient effect of short-term growth hormone (GH) treatment in short non-GH deficient prepubertal children
1Department of Paediatrics, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Insights
Short-term growth hormone (GH) therapy significantly boosts growth velocity in children lacking GH deficiency. However, this effect is temporary, with growth rates returning to baseline after treatment cessation.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Short stature in children can have various causes, including non-GH deficiency.
- Growth hormone (GH) therapy is a common treatment for growth disorders.
Purpose of the Study:
- To evaluate the efficacy of short-term growth hormone (GH) therapy in children with short stature but normal GH levels.
- To assess the long-term effects of GH therapy cessation on growth velocity.
Main Methods:
- Longitudinal study tracking 11 short non-GH deficient children.
- Measured growth velocity and serum IGF-1 levels before, during (1 year), and after (1-2 years) GH therapy.
Main Results:
- GH therapy significantly increased growth velocity (4.6 to 8.4 cm/year) and IGF-1 levels without affecting skeletal maturation.
- After stopping GH, growth velocity significantly decreased (to 2.4 cm/year) and returned to pretreatment levels within 2 years.
- The decline in growth velocity post-treatment was not attributable to age-related changes.
Conclusions:
- The height gain achieved with one year of GH therapy in short non-GH deficient children is largely transient.
- Short-term GH therapy may have limited long-term efficacy in this patient population.
Abstract:
This study reports the growth of 11 short non-GH deficient children before, during short-term GH therapy for 1 year and for 2 years after the cessation of treatment. The mean growth velocity increased significantly (p < 0.0001) from the pretreatment mean of 4.6 (SD = 0.95) cm/year to 8.4 (SD = 1.1) cm/year after 1 year of GH treatment without accelerated advancement of skeletal maturation. The serum IGF-1 levels also increased significantly with treatment. In nine children who remained prepubertal followed for one year after GH treatment, the mean growth velocity increased from 4.5 (SD = 0.69) cm/year before treatment to 8.7 (SD = 1.28) cm/year after 1 year of GH treatment (p < 0.0001). After stopping GH treatment, the growth velocity decreased significantly (p < 0.001) to 2.4 (SD = 0.68) cm/year during the first year of follow-up. In the six prepubertal children followed up for 2 years after treatment, the mean growth velocity was 4.1 (SD = 1.04) cm/year which was not significantly different from the pretreatment growth velocity. The significant decrease in growth velocity during the first post-treatment year could not be explained by the usual fall of growth velocity with increasing age in prepubertal children. Our results indicate that the effect of one year of GH treatment on height gain is partly transient and cast doubt on the efficacy of short-term GH therapy in short non-GH deficient patients.