Significant Improvement In Height Research Articles

Combined Use of Growth Hormone and Gonadotropin-Releasing Hormone Analogue in Short Normal Adolescent Girls: A Survey from Iran

Combined therapy with gonadotropin-releasing hormone (GnRH) analogue and growth hormone (GH) has been used to increase the height of adolescents who are not GH deficient and who have normally timed puberty. Its use, however, is still controversial. For 2 years simultaneously, we treated eight healthy girls with very low predicted adult height (PAH < 145 cm) who were entering into normally timed puberty. The GnRH analogue triptorelin pamoate (Decapeptyl, 100 microg/kg intramuscularly every 4 weeks) and GH (0.1 IU/kg/day subcutaneously, 6 days/week) were administered. The mean chronologic age (CA) of our patients was 11.01 +/- 0.95 years, and mean bone age (BA) was 12.25 +/- 1.13 years. With a height of 131.50 +/- 5.83 cm (-2.37 +/- 0.35 SD below the mean) and PAH of 140.87 +/- 3.53 cm, they were all in Tanner stage 2-3 of puberty (except one patient in stage 4). In all cases, GH and thyroid hormone deficiency were ruled out before the study began. Height and BA were measured immediately after discontinuation of therapy. PAH was determined before and at the end of therapy. Combined treatment resulted in a 4.13 +/- 1.19 cm increase in PAH (p < 0.01). Height increased significantly to 142.66 +/- 3.54 cm at the end of treatment (p < 0.01). Height standard deviation score for CA increased from -2.37 +/- 0.35 to -2.32 +/- 0.67, showing no significant improvement (p = 0.5). Height age (HA)/BA ratio and BA/CA ratio both demonstrated significant growth during the treatment (p < 0.03 and p < 0.01, respectively), whereas HA/CA ratio did not improve significantly (p < 0.32). During treatment, puberty was completely suppressed in all cases. Combination therapy with GnRH analogue and GH resulted in significant improvement in height and PAH during therapy. Additional, and perhaps more long-term, studies are required to show whether this kind of treatment is effective in improving final adult height. The cost-benefit of such therapies should also be taken into account.

Effects of Growth Hormone Treatment on Cognitive Function and Head Circumference in Children Born Small for Gestational Age

Short stature is not the only problem faced by children born small for gestational age (SGA). Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence and behavioural problems. This paper summarizes the results of a randomized, double-blind, growth hormone (GH) dose-response study (1 or 2 mg/m²/day [∼0.035 or 0.07 mg/kg/day]) on growth, intelligence quotient (IQ) and psychosocial functioning in 79 children born SGA at the start, and after 2 and 8 years of GH therapy, and addresses the associations with head circumference. Mean age at start of therapy was 7.4 years; mean duration of GH treatment was 8.0 years. In 2001, 91% of children born SGA had reached a normal height (> –2.0 standard deviation score [SDS]). Block-design s-score (Performal IQ) and Total IQ score increased (p< 0.001 for both indices) from scores significantly lower than those of Dutch peers at the start of therapy (p < 0.001) to scores that were comparable to those of Dutch peers in 2001. Vocabulary s-score (Verbal IQ) was normal at the start of therapy and remained so over time. Externalizing Problem Behaviour SDS and Total Problem Behaviour SDS improved during GH therapy (p < 0.01–0.05) to scores comparable to those of Dutch peers. Internalizing Problem Behaviour SDS was comparable to that of Dutch peers at the start of therapy and remained so, whereas Self-Perception improved from the start of GH therapy until 2001 (p < 0.001), when it reached normal scores. Head circumference SDS at the start of GH therapy and head growth during GH therapy were positively related to all IQ scores (p < 0.01), whereas neither were related to height SDS at the start of, or to its improvement during, GH therapy. A significant improvement in height and head circumference in children born SGA was seen after only 3 years of GH therapy, in contrast to randomized SGA controls. In conclusion, most children born SGA showed a normalization of height during GH therapy and, in parallel to this, a significant improvement in Performal IQ and Total IQ. In addition, problem behaviour and self-perception improved significantly. Interestingly, Performal, Verbal and Total IQ scores were positively related to head circumference, both at the start of, and during, GH therapy; head circumference increased in GH-treated children born SGA, but not in untreated SGA controls. These results are encouraging but also warrant confirmational studies and further investigations into the effects of GH on the central nervous system.

Growth hormone treatment enhances nutrition and growth in children with cystic fibrosis receiving enteral nutrition

Impaired longitudinal growth and poor weight gain are common and important problems in children with cystic fibrosis. This study evaluates the hypothesis that adjunctive growth hormone (GH) therapy augments the growth response to nutritional supplementation. We recruited 18 prepubertal children who received enteral nutritional supplementation for at least 2 years before enrollment. Nine were randomly assigned to receive no GH for 1 year, followed by 1 year of GH. Nine were randomly assigned to receive 1 year of GH followed by a second year of GH. Measurements included height, weight, pulmonary function, lean tissue mass, bone mineral content, hospitalizations, outpatient antibiotic use, and caloric intake. Growth hormone resulted in significant improvement in height, weight, bone mineral content, lean tissue mass, and number of hospitalizations. Pulmonary function was similar at baseline. Absolute forced vital capacity and forced expiratory volume in 1 minute significantly increased in GH treatment, but there was no significant change in percent predicted pulmonary function. Caloric intake was similar in both groups during both years. These results suggest that GH is a useful for enhancing growth in children with cystic fibrosis receiving enteral nutritional supplementation.

Nutritional Status and Growth in Children Less than 12 kg Treated with Continuous Ambulatory Peritoneal Dialysis

Various parameters of nutritional status and growth in 13 children with weight less than 12 kg were estimated at the start of continuous ambulatory peritoneal dialysis (CAPD) and 1 year later. A significant improvement in weight, triceps skinfold, and serum albumin was noticed. Height and midarm muscle circumference did not change significantly. However, a significant improvement in height occurred in patients with initial abnormal height (<--2 SDS). There was no significant change in protein intake and urea nitrogen appearance (UNA) during the study period. A significant correlation between protein intake and UNA was noticed. All patients had normal serum insulinlike growth factor. In conclusion, there was no significant change in either height velocity or muscle mass despite the improvement in many nutritional parameters.

Effects of an artificial diet on growth of patients with cystic fibrosis.

The effects of an artificial diet on growth were examined in a controlled trial on 43 patients with cystic fibrosis. 28 patients received the diet for 12 months. Comparison was made between their growth before, during, and after dietary treatment. Growth changes were also assessed in 15 other patients who received a conventional diet. Artificial dietary treatment led to some improvement in height, weight, subscapular skinfold thickness, and a disproportionate advance of bone age for the group as a whole. Only 10 (36%) patients had a 'clinically' significant improvement in height, weight, or both--i.e. more than 0.5 standard deviation score. Greatest improvements were in young and mildly affected patients. It is proposed that the future use of such an unpleasant and expensive diet should be restricted to a few selected cases, rather than given as routine treatment.