One-year Growth Hormone (GH) Treatment in Children with Non-endocrine Short Stature

Abstract

The effect of one year of human growth hormone (hGH) treatment on height velocity, height SDS, height velocity SDS and bone age was studied in 71 children with non-endocrine short stature. At the start of hGH treatment, mean chronological age (CA) was 8.75 yr, mean bone age (BA) 6.63, mean height SDS -3.09SD, mean height velocity 4.4 cm/yr, mean height velocity SDS for CA -1.66SD and mean height velocity SDS for BA was -2.19SD. Subjects were divided into four groups: 22 cases with familial short stature (M 14, F 8). 16 cases with SFD short stature (M 11, F 5), 5 cases with both familial and SFD short stature (M 5), and 28 cases with idiopathic short stature (M 20, F 8). There was no significant difference in height SDS, height velocity, mean peak GH and mean sleep GH before treatment among these four groups. The children received rhGH at a dose of 0.5U/kg/week 6-7 times a week subcutaneously.During hGH treatment, 8 cases developed pubertal sign. Since there was no significant difference in the effect hGH treatment between prepubertal group and pubertal group, both group were analyzed together. After one-year hGH treatment, mean height SDS increased significantly to -2.63SD (+0.44SD), mean height velocity to 7M5 cm/yr (+2.63cm/yr), height velocity SDS for CA to+ L62 SD (+3.84SD) and height velocity SDS for BA to +1.63SD (+ 3.845D). There was no significant difference in these values among four groups. During hGH treatment, plasma IGF- I levels increased significantly, but serum osteocalcin levels remained at the same level. Bone age advanced 1.57 years and height age advanced 1.20 years during one-year hGH treatment. The mean ratio of δ bone age/δ height age was 1.34. The effectiveness judged by δheight velocity ≥2cm was 67.6% and that was 62.0% judged by Aheight velocity SDS≥2.5SD. There was no significant difference in these effectiveness among four groups.Short-term hGH treatment was useful in children with non-endocrine short stature. However, long-term effects remained to be clarified.