Effect of Growth Hormone Therapy in Indian Children with Short StatureA Retrospective Study

Abstract

Introduction: The causes for short stature are multifactorial. The recombinant Growth Hormone (rGH) is used worldwide for its treatment however there is paucity of data on use of growth hormone in Indian Children. Aim: To study the effect of rGH in Indian children with short stature who were enrolled under ESIC scheme. Materials and Methods: This was a retrospective observational study. Subjects who had short stature (≤2SD) and diagnosed to have Growth Hormone Deficiency (GHD) by stimulation test and other causes for which growth hormone was indicated were enrolled. All subjects received treatment at ESI PGIMSR Basaidarapur, New Delhi, India, from July 2016 to July 2020, without discontinuation for more than one week. The data regarding gain in height was collected at the end of first year and then at the end of second year. Height velocity and change in Height SD were calculated (Mean±Standard Deviations). The associations and correlations were calculated by Spearman correlation test. Results: This study included data of 27 children (19 male and 8 female) with short stature. The mean age at treatment initiation was 9.85 years±3.04. The most common aetiology for which growth hormone was started was Idiopathic GHD (IGHD) seen in (15/27) 55.5% followed by Multiple Pituitary Hormone Deficiency (MPHD) 18.5% (5/27). The mean height and height SD at baseline was 111.76 cm ±17.40 and -3.85±1.19 (-6.0 to -1.5), respectively. The mean bone age delay (chronological age-bone age difference) was 40.96±25.58 months. The height velocity response was maximum during the first year of treatment (8.74±2.59 cm), declining to 8.13±2.30 cm in the second year. Correlation of the treatment response with age at treatment initiation, bone age delay and MPH was not significant. Conclusion: It was found that the growth velocity was significantly increased after one year of treatment. The study provides long term follow-up and response to rGH Treatment (rGHT) in Indian children enrolled under ESIC scheme however prospective studies with large sample size and longer follow-up duration which can report final height outcomes are needed.