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Zhao Q, Li R, Shao Q, Zhang M, Ban B. Recombinant growth hormone improves growth and adult height: a comparison between treated and untreated patients with idiopathic growth hormone deficiency. Transl Pediatr 2025; 14:442-451. [PMID: 40225070 PMCID: PMC11983003 DOI: 10.21037/tp-2024-576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Accepted: 03/04/2025] [Indexed: 04/15/2025] Open
Abstract
Background Recombinant human growth hormone (rhGH) is a standard treatment for idiopathic growth hormone deficiency (IGHD) patients to normalize growth. Prior studies on children mainly focused on short-term growth velocity effects, with limited long-term data on adult height outcomes. This study aims to assess adult height outcomes in patients with and without rhGH treatment, as well as evaluate the efficacy of rhGH treatment in individuals with IGHD. Methods A total of 169 individuals with IGHD who had attained their adult height were recruited. The related clinical and laboratory data, including anthropometric parameters, insulin-like growth factor-1 (IGF-1) levels, and the peak growth hormone (GH) levels, were collected. To assess the effectiveness of rhGH treatment, we evaluated the increase in final adult height and height standard deviation score (SDS). Results The final adult height SDS was -0.78 (interquartile range: -1.78 to 0.45) in the rhGH untreated group and -0.45 (interquartile range: -1.13 to 0.05) in the rhGH-treated group. The study results revealed that, in the IGHD population, the final adult height SDS and the increase in height SDS in the rhGH treatment group were significantly greater than those in the untreated group (P<0.05). Furthermore, the results of multiple regression analysis showed a significant increase in adult height SDS in patients treated with rhGH compared to those not treated with rhGH (β=0.41, 95% confidence interval: 0.14, 0.69; P=0.003) in the IGHD population. The baseline height SDS, peak GH, and rhGH treatment significantly affected the final adult height and height SDS gain in the IGHD population. Conclusions Our findings demonstrate that rhGH treatment effectively improves the final height SDS and height SDS gain in children with IGHD.
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Affiliation(s)
- Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Rong Li
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Qian Shao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
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Lonero A, Giotta M, Guerrini G, Calcaterra V, Galazzi E, Iughetti L, Cassio A, Wasniewska GM, Mameli C, Tornese G, Salerno M, Cherubini V, Caruso Nicoletti M, Street ME, Grandone A, Giacomozzi C, Faienza MF, Guzzetti C, Bellone S, Parpagnoli M, Musolino G, Maggio MC, Bozzola M, Trerotoli P, Delvecchio M. Isolated childhood growth hormone deficiency: a 30-year experience on final height and a new prediction model. J Endocrinol Invest 2022; 45:1709-1717. [PMID: 35567736 DOI: 10.1007/s40618-022-01808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE We aimed to evaluate the near-final height (nFHt) in a large cohort of pediatricpatients with growth hormone deficiency (GHD) and to elaborate a new predictive method of nFHt. METHODS We recruited GHD patients diagnosed between 1987 and 2014 and followed-up until nFHt. To predict the values of nFHt, each predictor was run in a univariable spline. RESULTS We enrolled 1051 patients. Pre-treatment height was -2.43 SDS, lower than parental height (THt) (-1.09 SDS, p < 0.001). The dose of recombinant human GH (rhGH) was 0.21mg/kg/week at start of treatment. nFHt was -1.08 SDS (height gain 1.27 SDS), higher than pre-treatment height (p < 0.001) and comparable to THt. 1.6% of the patients were shorter than -2 SDS from THt. The rhGH dose at nFHt was 0.19 mg/kg/week, lower than at the start (p < 0.001). The polynomial regression showed that nFHt was affected by gender, THt, age at puberty, height at puberty, age at the end of treatment (F = 325.37, p < 0.0001, R2 87.2%). CONCLUSION This large national study shows that GHD children can reach their THt. The rhGH/kg/day dose significantly decreased from the start to the end of the treatment. Our model suggests the importance of a timely diagnosis, possibly before puberty, the beneficial effect of long-term treatment with rhGH, and the key-role of THt. Our prediction model has a very acceptable error compared to the majority of other published studies.
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Affiliation(s)
- Antonella Lonero
- Giovanni XXIII Children's Hospital, AOU Policlinico di Bari, piazza G.Cesare 11, Bari, Italy
| | - Massimo Giotta
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Giulia Guerrini
- Specialty School of Paediatrics - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy
- Pediatric Department, "V. Buzzi" Children's Hospital, University of Milan, Milan, Italy
| | - Elena Galazzi
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Cassio
- Department of Pediatric Endocrinology, Unit of Pediatrics, University of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Chiara Mameli
- Pediatric Department, "V. Buzzi" Children's Hospital, University of Milan, Milan, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Mariacarolina Salerno
- Department of Translational Medical Sciences, Paediatric Endocrinology Unit, University of Naples 'Federico II', Naples, Italy
| | - Valentino Cherubini
- Department of Women's and Children's Health, G. Salesi Hospital, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | | | - Maria Elisabeth Street
- Department of Mother and Child, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Anna Grandone
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Giacomozzi
- Unit of Pediatrics, Department of Maternal and Child Health, Carlo Poma Hospital, ASST-Mantova, Mantua, Italy
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Paediatric Unit, University of Bari "A. Moro", Bari, Italy
| | - Chiara Guzzetti
- SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico "A. Cao", ASSL Cagliari, Novara, Italy
| | - Simonetta Bellone
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | | | - Gianluca Musolino
- Ambulatorio di Auxologia ed Endocrinologia pediatrica, S.C. Pediatria, Ospedale Pediatrico "Filippo Del Ponte", ASST Sette Laghi, Varese, Italy
| | - Maria Cristina Maggio
- Department of Health Promotion, Maternal and Infantile Care, Department of Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Maurizio Delvecchio
- Giovanni XXIII Children's Hospital, AOU Policlinico di Bari, piazza G.Cesare 11, Bari, Italy.
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