RESPONSE TO HUMAN GROWTH HORMONE THERAPY ACCORDING TO AGE

Abstract

It has been suggested that initiation of human growth hormone (hGH) therapy at a young age is more effective that when iniciated at a later age. On the other hand it is known that final height does not correlate with age at start of treatment. We studied the growth pattern of 24 patients with idiopathic hypopituitarism treated with hGH for a period of 4-5 years. The patients were divided into 3 groups according to age at the initiation of therapy: group I n=6 X chronological age 2.74 (0.87 - 4.43 years) bone age 0.92 ± 0.66 years; group II n=7 X chronological age 7.79 years (5.07 - 9.80 years) bone age 4.19 ± 1.89 years; group III n=10 X chronological age 13.38 years (10.07 - 15.75 years) bone age 8.64 ± 2.19 years. Patients of group I changed their height SDS from -4.44 ± 0.63 to -2.90 ± 0,78 over 4.79 years of treatment (X of increment 1.54 ± 0.79); group II from SDS -4.15 ± 0.47 to -3.19 ± 0.32 over 4.94 years of treatment (X of increment 0.96 - 0.48) and group III from -4.77 ± 1.67 to -3.38 ± 1.39 over 5.05 years of treatment (X of increment 1.53 ± 0.99). Patients of group III attained final height of 155.5 ± 6.07 cm at -2.88 ± 0.91 SD of the normal mean. Growth response pattern was the same in the 3 groups of patients. Better impact on final height seems to be due to a longer time of treatment. Patients of group I attained at 7.53 years of age the same height standart deviation score as that of the final height of patients who started therapy at a later age.