Variable response to growth hormone therapy in growth hormone deficient patients and role of insulin like growth factor one in monitoring response to therapy

Abstract

Background and objectives: To find out the response to growth hormone therapy among growth hormone deficiency patients with different causes and to find out the role of insulin-like growth factor one in monitoring response. Methods: This retrospective study was done on fifty patients who received growth hormone for short stature due to different causes. The patients were enrolled in the study that was conducted from June 2015 to December 2015 in Helina center- Erbil. All details including history, examination, investigations, treatment and follow-up were revised. Investigations that have been sent for each patient were full blood count, thyroid function tests, bone age assessment, growth hormone stimulation and insulin like growth factor one. Follow-up for their response clinically and by investigations have been done after 3, 6 and 12 months and after two years from initiating growth hormone therapy. Patients were divided to three groups, patients on 25 mcg/kg/day therapy (Group One), patient on 30 mcg/kg/day (Group Two) and patients on 35 mcg/kg/day (Group Three). The response to growth hormone therapy of the three groups was compared. Results: Among those fifty patients, only five patients discontinued their treatment. Significant height gain was observed after two years of regular growth hormone therapy. We found that with increasing the dose of growth hormone, the patient gain more height, and had higher insulin-like growth factor one, with p<0.05 between the groups. The mean height gain over 2 years of growth hormone therapy was 11.16 cm in Group One and 16.25 cm in Group Three. Conclusions: We conclude that by giving growth hormone to short children for a period not less than two years, height will increase significantly. Giving higher allowed doses gives higher increment compared to lower doses and insulin like growth factor one is a good tool for follows-up response to therapy.