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Growth response to growth hormone therapy in patients with different degrees of growth hormone deficiency
1Executive Scientific Committee, International Cooperative Growth Study (ICGS), Japan.
Insights
Growth response to growth hormone (GH) therapy in children with GH deficiency (GHD) depends on the severity of the condition. Patients with more severe GHD show a better response to GH treatment.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Idiopathic Growth Hormone Deficiency
Background:
- Growth hormone (GH) therapy is crucial for prepubertal patients with idiopathic GH deficiency (GHD).
- Understanding factors influencing treatment response is essential for optimizing outcomes.
Purpose of the Study:
- To analyze the growth response to GH therapy in prepubertal patients with GHD.
- To investigate the impact of chronological age and GH secretory capacity on treatment outcomes.
Main Methods:
- Utilized the International Cooperative Growth Study (ICGS) Japan database of 1192 patients (aged 3-10 years).
- Patients were stratified into three groups based on maximum GH values during stimulation tests (< or = 5 ng/ml, 5-10 ng/ml, > 10 ng/ml).
- Analyzed age-related growth response using delta height SDS and employed regression analysis to identify predictors of response.
Main Results:
- Patients with the most severe GH deficiency (GH values <= 5 ng/ml) demonstrated a significantly better growth response to GH therapy.
- Chronological age and Insulin-like Growth Factor-I (IGF-I) negatively correlated with growth response.
- Predictors accounted for 49% of growth response variation in the severe GHD group, versus 28% in less severe groups.
Conclusions:
- Growth response to GH therapy is closely related to the degree of GH impairment, with a notable cut-off level around 5 ng/ml.
- Treatment regimens for GHD should be individualized based on the severity of the deficiency.
- These findings highlight the importance of assessing GH secretory capacity for tailoring GH therapy.
Abstract:
Growth response to GH therapy in prepubertal patients with idiopathic GH deficiency (GHD) was analyzed in terms of the chronological age at the start of GH treatment and the GH secretory capacity, by using the large database provided by the International Cooperative Growth Study (ICGS) Japan. 1192 patients, aged from 3 to 10 years were divided into three groups with the following maximum GH values in GH stimulation tests: Group A: both < or = 5 ng/ml, group B: both 5-10 ng/ml, group C: one > 10 ng/ml. Analysis of age-related growth response using with delta height SDS (delta height SDS) as a response variable revealed that the group A patients responded better to GH, while there was no differences between the other groups. Simple and multiple regression analysis showed that IGF-I and chronological age (CA) negatively correlated with growth response, and target height SDS-height SDS positively correlated. These three most important predictors accounted for 49% of the variation in the growth response in group A, whereas six variables such as CA, frequency of GH injection, % overweight, GH dose, target height-height SDS, and pretreatment height velocity SDS accounted for only 28% of those in groups of B and C. These results lead us to conclude that growth response to GH is related to the degree of GH impairment with its cut-off level of 5 ng/ml. From these findings it might be suggested that treatment regimen should be tailored to individual requirements according to the degree of GHD.