Impact of growth hormone treatment on children’s height
Abstract
Background The use of growth hormone (GH) is a routine treatment for growth hormone deficiency (GHD), small for gestational age (SGA), and Turner syndrome (TS). During the treatment, height measurement at regular intervals is a vital step to assess success. To date, there have been no previous studies on GH treatment in Dr. Soetomo Hospital, Surabaya, the referral hospital in East Indonesia.
Objective To compare body height between pre- and post-growth hormone treatment in pediatric patients.
Method This study was a non-randomized, pre-post clinical trial performed at Dr. Soetomo Hospital, Surabaya. The prospective cohort was accessed during January 2008-June 2013. The inclusion criteria was GH treatment for more than 3 months.
Clinical data on GH treatment, including diagnosis, age, height pre-and post-treatment, height gain, duration of treatment, and parental satisfaction were collected. Two-tailed, paired T-test and Pearson’s test were used for statistical analyses.
Result Nineteen patients underwent GH treatment during the study period, but only twelve patients had complete data and were included in the study. Eight subjects were female. Subjects’ mean
age was 11 (range 8-15) years. Nine patients had GHD, 2 had TS, and 1 had SGA. Mean pre-treatment height was 121.05 cm, while mean post-treatment height was 130.5 cm. Mean duration of treatment was 10.5 (range 3-30) months. Mean height gain was 0.8 cm/month in GHD and SGA cases, and 0.78 cm/month for the TS cases. Eleven parents reported satisfaction with the results of GH treatment in their children. There is significant diffrent between pre- and post-treatment (P=0.001). Pearson’s correlation test (r=0.90) revealed a strong correlation between growth hormone treatment and height gain.
Conclusion Growth hormone treatment has impact on heights in GH defficiency, Turner syndrome, and small for gestational age.
References
Wilson TA, Rose SR, Cohen P, Rogol AD, Backeljauw P, Brown R, et al. Update of guidelines for the use of growth hormone in children: the Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee. J Pediatr. 2003;143:415-21.
Committee for Proprietary Medicinal Product (CPMP) opinion following an article 7(5) referral Norditropin. 2003; [cited 26 June 2003]; 3,478: Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Norditropin_7_5/WC500013722.pdf.
Kirk J. Indications for growth hormone therapy in children. Arch Dis Child. 2012;97:63-8.
Richmond E, Rogol AD. Current indications for growth hormone therapy for children and adolescent. In: Hindmarsh PC, editor. Current indications for growth hormone therapy. 2nd edition. London: Karger; 2010. p.92-108.
Clayton PE, Cianfarani S, Czernichow P, Johannsson G, Rapaport R, Rogol AD. Management of the child born small for gestational through adulthood: a consensus statement. J Clin Endocrinol Metab. 2007;92:804-10.
Fergusson Smith MA. Karyotype-phenotype correlations in gonadal dysgenesis and their baring on the pathogenesis of malformations. J Med Genet 1965;2:142-55.
Maneatis T, Baptista J, Connelly K, Blethen S. Growth hormone safety update from the National Cooperative
Growth Study. J Pediatr Endocrinol Metab. 2000;13:1035-44.
Wilson DM, Frane J. A brief review of the use and utility of growth hormone stimulation testing in the NCGS: Do we need to do provocative GH testing? Growth Hormone & IGF Research. 2005;15:21–5.
Nicol LF, Allen DB, Chernichow P, Zeitler P. Normal growth and growth disorders. In: Kappy MS, Allen DB, Geffner ME, editors. Pediatric practice: endocrinology. New York: McGraw Hill Companies. 2010. p.40-3.
Bakker B, Frane J, Anhalt H, Lippe B, Rosenfeld RG. Height velocity targets from the national cooperative growth study for first-year growth hormone responses in short children. J Clin Endocrinol Metab. 2008;93:352–7.
Wacharasindhu S, Supornsilchai V, Aroonparkmongkol S, Srivuthana S. Diagnosis and growth hormone (GH) therapy in children with GH deficiency: experience in King Chulalongkorn Memorial Hospital, Thailand. J Med Assoc Thailand. 2007;90:2047-52.
Park P, Cohen P. Insulin-like growth factor I (IGF-I) measurements in growth hormone (GH) therapy of idiopathic short stature (ISS). Growth Horm IGF Res. 2005;15:S13–20.
Soliman AT, Abdul Khadir MM. Growth parameters and predictors of growth in short children with and without growth hormone (GH) deficiency treated with human GH: a randomized controlled study. J Trop Pediatr. 1996;42:281–6.
Bang P, Bjerknes R, Dahlgren J, Dunkel L, Gustafsson J, Juul A, et al. A comparison of different definitions of growth response in short prepubertal children treated with growth hormone. Horm Res Paediatr. 2011;75:335–45.
Prasad Hk, Khadilkar VV, Chiplonkar Sa, Khadilkar AV. Growth of short children born small for gestational age and their response to growth hormone therapy. Indian Pediatr. 2013;50:497-9.
Chernausek SD, Attie KM, Cara JF, Rosenfeld RG, Frane J. Growth hormone therapy of Turner syndrome: the impact of age of estrogen replacement on final height. J Clin Endocrinol Metab. 2000;85:2439–45.
Carel Jean-Claude, Butler G. Safety of recombinant human growth hormone. In: Hindmarsh PC, editor. Current indications for growth hormone therapy. 2nd ed. Endocr Dev Basel, Karger; 2010. p.40-54.
Desrosiers P, O’Brien F, Blethen S. Patient outcomes in the growth hormone monitor: the effect of delivery device on compliance and growth. Pediatr Endocrinol Rev. 2005;2:327-31.
Schwenk WF. Growth hormone therapy—established uses in short children. Acta Paediatrica. 2006;95:6–8. doi: 10.1111/j.1651-2227.2006.tb02406.x.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Accepted 2017-02-01
Published 2014-12-30
