A Comparison of Different Definitions of Growth Response in Short Prepubertal Children Treated with Growth Hormone
2011 (English)In: HORMONE RESEARCH IN PAEDIATRICS, ISSN 1663-2818, Vol. 75, no 5, 335-345 p.Article in journal (Refereed) Published
Background: How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial. Aim: Assess various criteria of poor response. Subjects and Methods: Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) <=-2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS -3.2. Results: Median [25-75 percentile] first-year gain in Ht SDS was 0.65 (0.40-0.90) and height velocity (HtV) 8.67 (7.51-9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 mu g/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5. Conclusion: Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.
Place, publisher, year, edition, pages
2011. Vol. 75, no 5, 335-345 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-73939DOI: 10.1159/000322878PubMedID: 21228552OAI: oai:DiVA.org:liu-73939DiVA: diva2:478957