Effects of recombinant human growth hormone on height and skeletal maturation in growth hormone-deficient children with and without severe pretreatment bone age delay.
The relative effects of growth hormone (GH) on GH-deficient (GHD) children with and without severely delayed skeletal maturation prior to treatment are unclear.


METHODS
Pre-pubertal GHD children enrolled in the National Cooperative Growth Study were divided into two groups: severe pretreatment BA delay (BA Z-score </=-2, group 1) and mild to moderate delay (BA Z-score between -2 and 0, group 2). BA Z-scores (BAZ), height Z-scores and predicted adult height (PAH) Z-scores at pubertal onset were determined after initiation of recombinant human GH (rhGH) therapy.


RESULTS
Height Z-scores increased from baseline to the start of puberty in both groups (group 1: mean difference of +0.99, males and +1.02, females; group 2: +0.68, males and +0.75, females). Mean BAZ also increased in all group 1 children (+1.62, males and +1.08, females) with no corresponding change in mean BAZ in group 2. PAH Z-scores increased in both groups. There was no evidence of undue advance in BA since mean BAZ remained well below zero in group 1 and was unchanged in group 2.


CONCLUSIONS
rhGH has a beneficial effect on growth in prepubertal GHD children at all levels of pretreatment BA delay.
Frindik
J P
JP
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Ark., USA. frindikpaul@exchange.uams.edu
Kemp
S F
SF
Sy
J P
JP
D000328:Adult; D000365:Age Determination by Skeleton; D001827:Body Height / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects*; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000503:physiopathology*; D013006:Growth Hormone / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D024510:Muscle Development; D018482:Muscle, Skeletal / Q000187:drug effects / Q000254:growth & development*; D011627:Puberty; D012044:Regression Analysis; D012189:Retrospective Studies; D012727:Sex Characteristics
D019382:Human Growth Hormone; D013006:Growth Hormone