Adult Height After GH Rx of Idiopathic Short Stature

Abstract

Endocrinology| May 01 1999 Adult Height After GH Rx of Idiopathic Short Stature AAP Grand Rounds (1999) 1 (5): 39–40. https://doi.org/10.1542/gr.1-5-39 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Adult Height After GH Rx of Idiopathic Short Stature. AAP Grand Rounds May 1999; 1 (5): 39–40. https://doi.org/10.1542/gr.1-5-39 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: idiopathic short stature, prescriptions, drug Source: Hintz RL, Attie KM, Baptista J, Roche A. Effect of growth hormone treatment on adult height of children with idiopathic short stature. N Engl J Med. 1999;340:502–507. In a multicenter trial, Hintz et al examined the effect of growth hormone (GH) treatment on final stature in 121 healthy, prepubertal, short children with normal GH secretion (“idiopathic short stature”). Patients met four entry criteria: (1) height <3rd percentile; (2) growth rate <50% for age; (3) peak stimulated GH concentration >10mcg/L; and (4) bone age <9 (females) or 10 (males) years. Patients were randomly assigned to one year of observation without GH, or to an intervention group receiving GH (0.3 mg/kg/wk) for the first year. Thereafter, all children were treated with GH. Predicted heights were determined prior to treatment using the Bayley-Pinneau (B-P) tables and midparental target height was determined using conventional methods. Growth and final status in GH-treated children also were compared with those of untreated children followed in a separate study (the Fels Longitudinal Study, Yellow Springs, Ohio). Numerous pre-treatment variables were examined for predictability value in relationship to achieved final height. Eighty children completed 2–10 (mean 6) years of GH treatment and reached adult height. This group included 57 boys and 23 girls whose average age at baseline was 10 years. Fourteen left the study for “non-compliance,” 13 for “other reasons,” and 11 were “lost to follow-up.” All but 11 were said to have completed GH treatment at the time of the report. During the first year, GH-treated patients grew at a faster rate relative to those not treated. Furthermore, GH-treated patients achieved a final height greater than their pretreatment predicted adult height (+5.0±5.1 and +5.9±5.2 centimeters, males and females, respectively). The benefit was even more apparent when achieved adult height in GH patients was compared to the achieved adult height in untreated patients in the Fels comparison group: +9.2 cm difference in boys and +5.7 cm in girls. No pre-treatment factors appeared to be related to the difference between predicted and achieved adult height. Although achieved adult height was greater than predicted height in both males and females, final adult height remained ~5.5 cm less than mean mid-parental target height. Most prior studies have shown that GH therapy has no effect on the final adult height of heterogeneous groups of non-GH-deficient short children. In contrast, this study demonstrated about a 2-inch increment in final height. Methodologic issues may account for the discrepant results. Patient selection: Hintz et al studied children whose mean predicted adult height was very short—for girls 4′10″, for boys 5′3″—well below their mid-parental target heights of 5′2½″ for girls and 5′7″ for boys. Therefore, these study patients did not have familial short stature. Because timing of puberty was not reported, it cannot be discerned if some had constitutional delay of growth and adolescence. Prediction of adult height: The B-P method, which depends only on bone age and height, was the only method used to predict adult height. Other... You do not currently have access to this content.