THU178 Predicted Adult Height Outcomes And Relation To Final Adult Height In Children With Isolated Idiopathic Growth Hormone Deficiency Treated With rhGH Therapy

Abstract

Abstract Disclosure: B. Duong: None. K. Vu: None. A.S. Bhangoo: None. Background: Children with growth hormone deficiency (GHD) are treated with growth hormone therapy for multiple years. Once a year a bone age X ray is done to monitor the development of the epiphysial growth plates and to calculate the predicted adult height (PAH) by using the Bayley-Pinneau tables. There is not much quantitative data on the PAH calculations in relation to Final adult height (FAH) and Mid-parental height (MPH). Methods: We collected data on 42 children with isolated idiopathic GHD (9 females, 33 males). These children had finished GH therapy after multi-year treatment. Data on MPH, FAH and PAH baseline (prior to starting rhGH), 1 yr, 2 yr and 3 yr post treatment was collected, and correlation analysis was performed. Results: The PAH at baseline correlated with FAH (R2 of 0.62), the PAH underestimated the height on average by 2.9 cms with SDS of 5.9 cms. The PAH was >2SDS below the FAH in 42%, >2SDS above in only 8% of children. The PAH after 1 year of rhGH correlated with FAH (R2 of 0.69), the PAH started to slightly overestimate the height on average by 0.6 cms with SDS of 5.9 cms. The PAH after 2 year of rhGH correlated with FAH (R2 of 0.82), the PAH calculated overestimated the height on average by 2.5 cms with SDS of 4.4 cms. The PAH after 3 year of GH therapy correlated with FAH (R2 of 0.94), the PAH also overestimated as compared to FAH on average by 2.6 cms with SDS of 2.3 cms. The PAH was >2SDS above the FAH in only 12% and for 88% within 2SDS of FAH. The PAH at baseline correlated with MPH (R2 of 0.35), the PAH was less than MPH on average by 4.2 cms with SDS of 7.6 cms. The PAH was >2SDS below the MPH in 48% children, >2SDS above the MPH in only 12 %. The PAH after 1 year of rhGH therapy correlated with MPH (R2 of 0.43), the average PAH calculated slightly below the MPH by 0.56 cms with SDS of 7.8 cms. The PAH after 2 years of rhGH therapy correlated with MPH (R2 of 0.57), the PAH was calculated most close to MPH on average by 0.05 cms with SDS of 6.5 cms. The PAH after 3 years of rhGH therapy correlated with MPH (R2 of 0.59), the PAH was now calculated above the MPH on average of 1.08 cms with SDS of 6.1 cms. At 3 years the PAH was >2SDS above the MPH in 28% and >2SDS below in 18% and within range in 64% of children. Conclusion: The PAH correlation with the FAH and MPH grows stronger with successive 3 years of therapy. The PAH correlation was stronger with FAH as compared to MPH. The PAH underestimated the height outcome at the beginning of therapy and overestimated after 3 years of rhGH therapy. The strongest correlation between PAH and FAH was seen after 3 years. The variations in PAH as measured by SDS improved post treatment. These factors should be considered while considering the height trajectory of children receiving rhGH therapy and while counseling parents on child’s height outcome. Presentation: Thursday, June 15, 2023