Evaluation of the Final Adult Height and Its Determinants in Patients with Growth Hormone Deficiency: A Single-centre Experience from the South-Eastern Region of Turkey

Recombinant growth hormone improves growth and adult height: a comparison between treated and untreated patients with idiopathic growth hormone deficiency

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.

Isolated childhood growth hormone deficiency: a 30-year experience on final height and a new prediction model

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.