title: Effect of long-term growth hormone therapy on bone age and pubertal maturation in boys with and without classic growth hormone deficiency.
abstract: We evaluated the effect of growth hormone (GH) therapy on bone age, pubertal maturation and predicted adult height in two groups of boys treated for 4 years: 40 growth hormone-deficient boys who had growth hormone response to provocative stimulation < 10 micrograms/L (GHD group) and 43 boys whose stimulated growth hormone > or = 10 micrograms/L (group with neurosecretory dysfunction (NSD)). All patients had a subnormal integrated concentration of growth hormone < or = 3.2 micrograms/L, height < -2 SD, growth velocity < 4.5 cm/yr, and bone age < or = -2 SD for chronologic age. Patients were treated with recombinant growth hormone, 0.1 mg/kg per dose given three times a week. The pretreatment height SD of the GHD group (-3.6 +/- 1.0) was less than that of the NSD group (-2.7 +/- 0.7; p < 0.001). After 4 years of therapy, both groups had catch-up growth (GHD group to -2.0 +/- 1.3 height SD (n = 35), and NSD group to -1.4 +/- 0.7 height SD (n = 32)); the rate of height SD gain was better in patients with GHD (p < 0.01). The response to growth hormone was inversely related to pretreatment chronologic age (p < 0.001). The Tanner-Whitehouse II predicted adult height improved for both groups: +9.3 +/- 7.7 cm in the GHD group, giving an adult height SD of -0.9 +/- 1.0, and +5.4 +/- 5.5 cm in patients with NSD, for an adult height SD if -0.8 +/- 0.7. Testosterone levels became higher in the NSD group after 2 years and remained higher at year 4. We conclude that patients respond favorably to growth hormone therapy and in a manner similar to patients with GHD. Initiation of therapy at a younger age gives a greater improvement in gained height and predicted adult height.
authors.affiliation: Pediatric Endocrine Unit, Kaplan Hospital, Rehovot, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Zadik
authors.forename: S
authors.initials: S
authors.lastname: Chalew
authors.forename: A
authors.initials: A
authors.lastname: Zung
authors.forename: H
authors.initials: H
authors.lastname: Landau
authors.forename: E
authors.initials: E
authors.lastname: Leiberman
authors.forename: R
authors.initials: R
authors.lastname: Koren
authors.forename: H
authors.initials: H
authors.lastname: Voet
authors.forename: Z
authors.initials: Z
authors.lastname: Hochberg
authors.forename: A A
authors.initials: AA
authors.lastname: Kowarski
mesh_terms: D000365:Age Determination by Skeleton; D001827:Body Height / Q000187:drug effects*; D002648:Child; D006128:Growth / Q000187:drug effects*; D006130:Growth Disorders / Q000188:drug therapy*; D013006:Growth Hormone / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011627:Puberty / Q000187:drug effects*; D012044:Regression Analysis
chemical_list: D013006:Growth Hormone