Abstract
This paper assesses the factors which contribute to the ultimate result, as regards adult stature and body proportions, of long-term hGH treatment. It concerns 39 patients with idiopathic isolated GH deficiency (GHD), 10 with idiopathic GH plus gonadotrophin deficiency (GnD), 6 with idiopathic multiple hormone deficiency (MPHD) and 30 with multiple deficiencies following craniopharyn-giomas (CR). Treatment averaged 5½ years and terminated when growth ceased. Final height in isolated GHD averaged 2.3 SD below the population mean (untreated, about 6 SD). Half the boys, but only 15% of the girls ended above the 3rd centile. Pubertal development and the adolescent growth spurt were normal. The trunk/ limb proportion was normal. Final height was more affected by mid-parent height (correlation 0.72) than by any other factor, but the degree of smallness at initial treatment also, independently, affected it (partial correlation 0.37). Age at initial treatment, duration of treatment and first year velocity were uncorrelated with final height. Patients with GHD plus GnD, with MPHD and with CR ended up taller (-1.5, -1.0, -1.2 SD) but entirely because their legs were (disproportionately) longer. Length of leg and body proportions depend on when sex steroids are begun. These results indicate that the unrecovered 2 SD of height in GHD was lost early in childhood, and emphasise the importance of early diagnosis, before the patient's height is too far below normal standards.
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Tanner, J., Preece, M., Burns, E. et al. Final results of long-term hGH treatment in 55 patients with idiopathic GH deficiency and 30 patients with craniopharyngioma. Pediatr Res 15, 1542 (1981). https://doi.org/10.1203/00006450-198112000-00040
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DOI: https://doi.org/10.1203/00006450-198112000-00040