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A comparison of different definitions of growth response in short prepubertal children treated with growth hormone
Department of Women’s and Children’s Health, Karolinska Institute and University Hospital, Stockholm, Sweden.
Department of Clinical Medicine, Section for Pediatrics, University of Bergen, Norway.
Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
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2011 (English)In: Hormone research in paediatrics, ISSN 1663-2826, Vol. 75, no 5, 335-345 p.Article in journal (Refereed) Published
Abstract [en]

Background: How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial.

Aim: Assess various criteria of poor response.

Subjects and Methods: Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) ≤-2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS -3.2.

Results: Median [25-75 percentile] first-year gain in Ht SDS was 0.65 (0.40-0.90) and height velocity (HtV) 8.67 (7.51-9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 μg/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5.

Conclusion: Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.

Place, publisher, year, edition, pages
2011. Vol. 75, no 5, 335-345 p.
Keyword [en]
Growth hormone therapy, Growth response, Height velocity, Growth hormone deficiency, Organic growth hormone deficiency, Small for gestational age, Idiopathic short stature, Turner syndrome, Skeletal dysplasia, Growth prediction
National Category
Endocrinology and Diabetes Pediatrics
URN: urn:nbn:se:umu:diva-39706DOI: 10.1159/000322878PubMedID: 21228552OAI: diva2:395178
Available from: 2011-02-04 Created: 2011-02-04 Last updated: 2012-03-29Bibliographically approved

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