title: Craniofacial and acral growth responses in growth hormone-deficient children treated with growth hormone.
abstract: 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.
authors.affiliation: Pediatric Endocrinology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Segal
authors.forename: Ora Hirsch
authors.initials: OH
authors.lastname: Pescovitz
authors.forename: G Bradley
authors.initials: GB
authors.lastname: Schaefer
authors.forename: Linda A
authors.initials: LA
authors.lastname: DiMeglio
mesh_terms: 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
chemical_list: D019382:Human Growth Hormone