Abstract
BACKGROUND: Growth hormone (GH) has been proved to increase height velocity (HV) in some shoit children who are not GH deficient. OBJECTIVE: Multivariate discriminant analysis was employed to identify, using pre-treatment auxological data, the children responsive to GH. DESIGN: Open prospective study. SETTING: University hospital. SUBJECTS: Fifty-five (35 males) patients that met the following criteria were studied: birth weight >2.500 Kg; no signs of dysmorphic disease; stature below the 3rd centile for chronological age (CA); height velocity below the 25th centile for bone age (BA); no signs of puberty; growth hormone response to pharmacological stimulation >10 ng/ml; no evidence of organic disease; treatment with daily subcutaneous administrations of GH at the dosage of 12-16 UI/m2/week. MAIN OUTCOME MEASURES: Eight pre-treatment auxological variables; HV increase after six months of therapy. A HV increase >2.5 cm/y was considered as a positive response.
RESULTS: Thirty-tvvO (58.2%) patients were responsive. Using univariate analysis, the variables found to have predictive value (p<0.001) were: height velocily (SD for CA) and bone age (SD). These variables were employed in the multivariate discriminant analysis. The equation obtained was: Score=1.09X1 - 0.83X2 + 0.19 (X1=HV, X2=BA). Using this scoring system we obtained a sensitivity of 95.7% and a specificity of 91.0% in predicting responsiveness to GH (X2 with Yates correction=36.78, p<0.0001). No correlation was found between responsiveness and GH dosage. CONCLUSIONS: Discriminant analysis may permit the pre-treatment prediction of response to GH therapy in short children and therefore the identification of patients in which GH would be useless.
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Spagnoli, A., Spadoni, G., Pasquino, A. et al. IDENTIFICATION OF RESPONSIVE AND UNRESPONSIVE SHORT CHILDREN TO GROWTH HORMONE THERAPY USING A MULTIVARIATE DISCRIMINANT ANALYSIS OF PRE-TREATMENT AUXOLOGICAL DATA. Pediatr Res 33 (Suppl 5), S57 (1993). https://doi.org/10.1203/00006450-199305001-00326
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DOI: https://doi.org/10.1203/00006450-199305001-00326