title: The mathematical model for total pubertal growth in idiopathic growth hormone (GH) deficiency suggests a moderate role of GH dose.
abstract: The role of GH treatment during total pubertal growth (TPG) is still unclear. We developed a prediction model for TPG (centimeters) through a multiple regression analysis of various prepubertal parameters in 303 adolescents with idiopathic GH deficiency from the KIGS database. Prepubertal catch-up growth and near-adult height were achieved, and GH dose was kept constant at approximately 30 micro g/kg.d. The model was validated on a cohort of 36 patients from one center. Four TPG predictors explained 70% of the variability with an error SD of 4.2 cm: gender (TPG in males was >11.3 cm vs. that in females), age at onset of puberty (negative), height SD score minus midparental height SD score at puberty onset (negative), and mean GH dose during puberty (positive). Our analysis suggests that TPG in idiopathic GH deficiency is only moderately dependent on GH dose. The use of a higher GH dosage at the onset of puberty should thus depend on the individual's height development. The TPG model aids in the planning of individually optimized and cost-effective GH treatment.
authors.affiliation: Pediatric Endocrinology Section, University Children's Hospital, Tubingen D-72076 Germany. michael.ranke@med.uni-tuebingen.de
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ranke
authors.forename: Anders
authors.initials: A
authors.lastname: Lindberg
authors.forename: David D
authors.initials: DD
authors.lastname: Martin
authors.forename: Bert
authors.initials: B
authors.lastname: Bakker
authors.forename: Patrick
authors.initials: P
authors.lastname: Wilton
authors.forename: Kerstin
authors.initials: K
authors.lastname: Albertsson-Wikland
authors.forename: Chris T
authors.initials: CT
authors.lastname: Cowell
authors.forename: David A
authors.initials: DA
authors.lastname: Price
authors.forename: Edward O
authors.initials: EO
authors.lastname: Reiter
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D015331:Cohort Studies; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency*; D006801:Humans; D008297:Male; D008954:Models, Biological; D011237:Predictive Value of Tests; D011627:Puberty / Q000187:drug effects* / Q000502:physiology; D012044:Regression Analysis; D015203:Reproducibility of Results
chemical_list: D019382:Human Growth Hormone