Abstract
GH therapy has been reported to accelerate growth, but also to expedite bone maturation and pubertal development. The present study was undertaken to evaluate the effect of these changes on HP, and it's relationship with the child's age. Sixty-five male patients with GH-deficiency, age range of 3.1-17.7 yr (11.3±3.2[SD]), were treated with hGH (0.3 mg/kg/wk), and completed 3 years of therapy. Of these, 33 were diagnosed by subnormal pharmacological tests, and 32 by low 24-hr profiles. HP were calculated annually by the TW-II, Roche, and Bailey-Pinneau methods. The advancement of bone maturation, calculated as [δ-bone age / δ-chronological age], as well as the pace of pubertal development, calculated as δ-Tanner stage over 3 years of therapy, correlated positively with age (p<0.001). Best-fit correlations and plots of age at outset of therapy [O-age] against the gained (or lost) HP for the 1st, 2nd or 3rd years of therapy, revealed insignificant correlations for the first 9.6-9.8 years of life, with mean gained HP of 4.5, 3 and 2.1 cm resp. With further increase in O-age δ-HP declined, with x-intercepts (δ-HP=0) at 12.6, 12.1 and 11.8 years of O-age, resp. (13.6, 14.1 and 14.8 actual [A] age, resp). The mean over-all 3 years gained HP was 7.9 cm for O-age 3.1-10.1 years, declining in older children to 0 cm at 13.1 years O-age (mean 16.1 years A-age), and to lost HP in older children. It is concluded that hGH therapy of GH-deficient children with this dose results in effective HP gain over the first decade of life, with decreasing efficacy thereafter, due to advancement of puberty and bone age and HP loss after the O-age of 13.1 years (A-age 16.1 yr).
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Hochberg, Z., Leiberman, E., Landau, H. et al. THE AGE DETERMINANT IN THE PREDICTED HEIGHT (HP) GAINED DURING GH THERAPY. Pediatr Res 33 (Suppl 5), S50 (1993). https://doi.org/10.1203/00006450-199305001-00280
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DOI: https://doi.org/10.1203/00006450-199305001-00280