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Final height outcome of growth hormone-deficient patients treated since less than five years of age
Insights
Early growth hormone (GH) treatment in GH-deficient infants can lead to significant height gains. Initiating therapy before age five is crucial for achieving optimal adult stature and reaching target height.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Growth hormone deficiency (GHD) in infants leads to significant growth failure.
- Long-term effects of early GHD treatment on adult height are critical to understand.
Purpose of the Study:
- To evaluate the long-term efficacy of growth hormone (GH) substitutive treatment in infants with GHD.
- To identify factors influencing final adult height in GHD patients treated from infancy.
Main Methods:
- Longitudinal study of 13 GHD infants treated with GH for at least 9 years.
- Analysis of growth parameters, including standard deviation scores (SDS) for height, target height, and final adult height.
Main Results:
- Patients achieved an average adult height near their target height, with 8/13 exceeding it.
- Height outcome correlated negatively with age at therapy initiation and positively with height at puberty onset.
- Early intervention (before age 5) was key for successful catch-up growth.
Conclusions:
- Substitutive GH therapy initiated in infancy can enable GHD children to reach their target percentile.
- Early initiation of GH treatment, ideally before 5 years of age, is essential for optimal final stature in GHD patients.
Abstract:
Thirteen growth hormone deficient infants underwent substitutive treatment for a least 9 years, since less than 5 years of age until adulthood. They presented with average growth failure reaching 4.1 SDS and attained an adult mean height close to target height. In eight subjects final height exceeded the respective target height and only three patients failed to achieve an end height within the target range. The analysis of the factors conditioning ultimate stature pointed out that height outcome correlated negatively with chronological age at therapy initiation and positively with height at puberty onset. It is concluded that full catch-up growth to target percentile is possible in growth hormone-deficient children, provided that substitutive treatment is begun within the 5 years of life. This conclusion is substantiated for the first time by data on end stature.