Growth Response in Prepubertal Children with Idiopathic Growth Hormone Deficiency During The First Two Years of Treatment with Growth Hormone

Abstract

Four hundred and eighty-one prepubertal patients who had completed 2 years of growth hormone (GH) treatment were selected from the database by International Cooperative Growth Study in Japan.1. In 481 prepubertal GH deficient (GHD) patients treated with Genotropin, the first-year height velocity (HV) and HV standard devistion score (SDS) were 7.5 and 2.4 and the second-year HV and HV SDS were 6.1 and 0.6 on average. The decrement of HV in the second year was 16%.2. The patients of complete GHD type had slower growth rates, higher target height, more adiposity, lower height SDS before treatment and better growth responses during the two years of treatment than those of partial or“neuro secretory dysfunction (NSD) ”type. Therefore the definition of the complete type as showing maximal stimulated GH levels below 5ng/ml is valid, considering these growth responses in two years.3. No distinction is made between partial type and“NSD”type, using the variables in this study.4. The degree of adiposity was related to the first year growth response, and weakly to the second year response.5. Simple and multiple regression analysis showed that during the first year of treatment, there was more growth in younger patients with slower HV, poorer GH secretion, increased adiposity and a higher number of injections per week. During the second year, correlations with variables significant in the first year became weaker, and the first-year growth responses were the main contributing factors to the second-year growth responses. However, only one-fifth to one-half of the growth responses were explained by the variables in this study, and some other unknown factors may be involved in height increase during therapy.