Abstract
There is a need for better criteria for initiation of growth hormone (GH) treatment in children. The aim of this study was therefore to identify possible predictors of the growth response to GH treatment in short children of different GH staus, especially growth data from birth to two years of age.
Prepubertal children (n=206) treated for at least two years with GH (0.1 U/g x day) were included. Their maximal GH response to provocation test ranged from 0-80 mU/L. At start of treatment the mean age was 8.4 years (range 2.6-15.4 years) and mean height −3.0 SDS. The individual 2 years growth response was correlated with the log GHmax at AITT (r=−0.40), the midparental height SDS (r=0.33), the age at start of treatment (r=−0.32), the height SDS at start of treatment (r=−0.21), delta SDS value (r=−0.21) and the difference between the height SDS at onset of GH treatment of an individual child and the midparental height SDS, (diff SDS; r = −0.42).
The growth response during the first two years of treatment could be predicted in a multiple regression model to 33% in terms of GH^max at AITT and the diff SDS. We also found that the GHmax at AITT and the diff SDS both were positively correlated to birth length and height velocity during the first and second year of life as well as to the pretreatment height velocity, The complex etiology of being short, involving genetic potential, growth disturbances in the past, and GH secretion may explain the relatively low prediction of the growth response using ordinary multivariable analysis. Another approach would be to subgroup the children in terms of background variables before applying some predictive models. For instance on two years of CH treatment the children with low GHmax increased 1.8 SDS independently of birthlenght, whereas the growth response in children with high GHmax was positively related to birthlenght; 1.2 SDS in normal birthlength children vs 0.8 SDS in low birthlenglh children.
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Kriström, B., Karlberg, J. & Albertsson-Wikland, K. PREDICTION OF GROWTH RESPONSE IN GROWTH HORMONE (GH) TREATED SHORT PREPUBERTAL CHILDREN - INFLUENCE OF GROWTH IN EARLY LIFE. Pediatr Res 33 (Suppl 5), S53 (1993). https://doi.org/10.1203/00006450-199305001-00301
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DOI: https://doi.org/10.1203/00006450-199305001-00301