Predicting and monitoring of growth in children with short stature during the first year of growth hormone treatment.
Fifteen prepubertal short stature children (10 girls, 5 boys), mean age 9.6 years (range 5.2-12.7 years), with normal response to growth hormone stimulation tests (group A) or partial growth hormone deficiency (GHD) of idiopathic nature (group B) were included in a controlled longitudinal study for evaluation of predictive parameters for the long-term growth response after administration of biosynthetic human growth hormone (B-hGH). The average knee-heel length velocity for the first 3 months was significantly correlated to total body height velocity during the following 9 months (p less than 0.0008). By contrast, this association could not be found for height velocity during the same period. The increase in serum values of alkaline phosphatase and insulin-like growth factor I (IGF-1) during the first month of treatment was not significantly correlated to height velocity during the first year. During one year of treatment with B-hGH the mean height velocity for groups A and B increased from 4.4 cm/year (range 2.5-6.5) to 7.6 cm/year (range 4.7-10.6). Bone age advanced by 1.08 +/- 0.60 per chronological year. The ratio between total height and knee-heel length prior to treatment was 3.34 +/- 0.10 and after one year 3.33 +/- 0.10, suggesting a proportional linear growth. An inverse relationship was observed between the ratio and chronological age. In conclusion, early knee-heel measurement may be a useful non-invasive predictor of long-term linear growth in children during treatment with growth hormone, and the ratio of total height to lower leg length may be of importance in detecting dysproportional growth.
Mortensen
H B
HB
Department of Growth and Reproduction Rigshospitalet, Novo Nordisk, Denmark.
Main
K
K
Michaelsen
K F
KF
Kastrup
K W
KW
Jłrgensen
J T
JT
Skakkebaek
N E
NE
D000365:Age Determination by Skeleton; D000469:Alkaline Phosphatase / Q000097:blood; D000886:Anthropometry; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007866:Leg / Q000033:anatomy & histology*; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D000469:Alkaline Phosphatase