title: Earlier initiation of GH therapy does not influence adult height but enables earlier start of pubertal induction in children with multiple pituitary hormone deficiency.
abstract: OBJECTIVE
  For patients with GH and gonadotrophin deficiency, adult height and sexual maturation are important not only for their physical but also psychological status. GH therapy is usually initiated soon after diagnosis but the differences in the age for initiation of therapy have not been previously examined. In this study, we assessed the influence of timing of initiation of GH therapy on adult height and the time of initiation of pubertal induction.
  
  
  METHODS
  Height-related data from 16 short children (13 boys and three girls) with GH and gonadotrophin deficiency who reached adult height after 10.9 +/- 2.3 years of GH therapy were analysed retrospectively.
  
  
  RESULTS
  Adult height (0.00 +/- 0.69 SD) improved remarkably compared to height SDS at the start of GH therapy (-3.75 +/- 0.94 SD). The age at which GH therapy was started ranged from 3.2 to 12.0 years, but we found that such a difference in age did not affect adult height. However, an earlier start of GH therapy allowed earlier pubertal induction without loss of height potential.
  
  
  CONCLUSIONS
  Earlier initiation of GH therapy is not required for normalization of adult height in patients with GH and gonadotrophin deficiency but it makes earlier pubertal induction possible, which is important for quality of life.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kyoto University, Kyoto, Japan. masahiko@kuhp.kyoto-u.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawai
authors.forename: Toru
authors.initials: T
authors.lastname: Momoi
authors.forename: Mitsukazu
authors.initials: M
authors.lastname: Mamada
authors.forename: Tohru
authors.initials: T
authors.lastname: Yorifuji
authors.forename: Tatsutoshi
authors.initials: T
authors.lastname: Nakahata
mesh_terms: D000367:Age Factors; D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency*; D006801:Humans; D008297:Male; D010907:Pituitary Hormones / Q000172:deficiency*; D011627:Puberty / Q000187:drug effects*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D010907:Pituitary Hormones; D011994:Recombinant Proteins; D019382:Human Growth Hormone