ArticlesFinal height of short normal children treated with growth hormone
Introduction
Growth rate is related asymptotically to the amount of growth hormone (GH) secreted.1 This function predicts that the smallest children growing most slowly and secreting least GH would respond best to exogenous GH.2 Short children secreting sufficient GH to maintain near-normal growth velocity should grow faster with exogenous GH, although the response would be less, dose-for-dose, than those with GH insufficiency. Growth acceleration after administration of exogenous GH has been reported in heterogeneous populations of short children almost uniformly growing poorly. The definition of normality was based on the results of GH secretion tests, which may be suspect.3 We have reported first-year results of treatment with biosynthetic human GH (r-hGH) in children with normal pretreatment growth rates and normal responses to physiological and pharmacological testing.4 Here we report final heights in these children after daily teatment with r-hGH for 4–9 years and in an untreated observation group.
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Participants
Details of the participants and the inclusion and exclusion criteria have been reported.4
16 children were treated with r-hGH and 10 children, whose families did not wish to proceed with the treatment, formed the observation group. The main reason for declining intervention was the need for frequent r-hGH injections.
Assessments
Standard growth asseessments were made every 3–4 months. Coefficients of variation in height measurements were 0·1 and 0·05% at heights of 120 and 150 cm, respectively. Bone age was
Results
Of the 16 children enrolled, 15 have attained final height (no growth or growth velocity <0·5 cm per year with adult bone maturation) after a median of 7·5 years' (range 4–9) treatment with r-hGH. In the remaining individual, final height SDS calculated as presently predicted height SDS has been used but exclusion of these data does not influence the results. The 7 children in the observation group have all attained final height. There were no significant differences in anthropometric status
Discussion
Our data demonstrate that treatment of short children with normal pretreatment growth rates with r-hGH increased stature by approximately 2·8 cm in boys and 2·5 cm in girls, which moved the children slightly closer to the target height dictated by their parents. These results do not support results from short-term studies but are in keeping with those reported by Loche et al10 and in children who were growing slowly but appeared to have an adequate GH secretory status.11
We used patients as
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