A comparison of different definitions of growth response in short prepubertal children treated with growth hormone

Horm Res Paediatr. 2011;75(5):335-45. doi: 10.1159/000322878. Epub 2011 Jan 12.

Abstract

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 μg/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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Pharmacological / analysis
  • Body Height / drug effects*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diagnostic Techniques, Endocrine*
  • Female
  • Growth Disorders / diagnosis*
  • Growth Disorders / drug therapy*
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Male
  • Prognosis
  • Puberty / drug effects
  • Puberty / physiology
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Biomarkers, Pharmacological
  • Human Growth Hormone