Craniofacial and acral growth responses in growth hormone-deficient children treated with growth hormone.
OBJECTIVE
To investigate the effects of growth hormone (GH) therapy on craniofacial growth and body proportions in growth hormone deficient children.


METHODS
By using a cross-sectional study design, we investigated GH effects on craniofacial growth with photographic facial morphometrics, head circumference, and hand and foot size in 52 children with GH deficiency (GHD) treated with GH (0.27 mg/kg/wk) for 0.19 to 15.5 years, compared with untreated children with GHD and normal first-degree relatives. To detect disproportion and to correct for stature, age and height age (HA) SD scores were analyzed.


RESULTS
Untreated subjects with GHD had retarded facial height and width (P values=.001) compared with normal controls; small head circumference for age and HA (P=.001); small hands for age (P<.001) that were large for HA (P=.003); and small feet for age (P<.001) that were normal for HA. When compared with normal controls, GH-treated subjects had proportional facial heights but narrower facial widths. Head circumference, however, increased disproportionately to height (P=.001), becoming large for stature, and increasing with duration of therapy and cumulative GH dose (P<.001). Hands and feet grew proportionately to height.


CONCLUSIONS
Growth hormone treatment with conventional doses partially corrects craniofacial deficits and does not adversely affect hand and foot growth but appears to result in excessive head circumference growth.
Segal
David G
DG
Pediatric Endocrinology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Pescovitz
Ora Hirsch
OH
Schaefer
G Bradley
GB
DiMeglio
Linda A
LA
D000886:Anthropometry; D001827:Body Height; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005145:Face / Q000033:anatomy & histology; D005190:Family; D005528:Foot / Q000033:anatomy & histology / Q000254:growth & development*; D006225:Hand / Q000033:anatomy & histology / Q000254:growth & development*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D008445:Maxillofacial Development; D012886:Skull / Q000033:anatomy & histology / Q000254:growth & development; D013997:Time Factors
D019382:Human Growth Hormone