title: Response to growth hormone with respect to pubertal status on increased dose in idiopathic growth hormone deficiency: an analysis of Turkish children in the KIGS database (Pfizer International Growth Study).
abstract: OBJECTIVE
  To compare the growth response to growth hormone (GH) treatment in patients with idiopathic GH deficiency (IGHD) who were prepubertal with the response of those who were pubertal at the onset of GH therapy on an increased GH dose.
  
  
  METHODS
  Among the Turkish patients enrolled in the Pfizer International Growth Study (KIGS) database with the diagnosis of IGHD, the growth data over 2 years of GH therapy were analyzed longitudinally of 113 (79 M) prepubertal (Group 1) and 44 (33 M) pubertal (Group 2) patients. Pubertal signs were reported to be present initially or to have appeared within 6 months of GH therapy in Group 2. Mean +/- SD age at onset of therapy was 8.7 +/- 3.5 and 13.5 +/- 1.8 years; height SDS -4.2 +/- 1.4 and -3.2 +/- 1.1 (p < 0.05) in Groups 1 and 2, respectively. Mid-parental height (MPH) SDS did not show a significant difference between the two groups (-1.5 +/- 1.1 vs -1.7 +/- 1.1).
  
  
  RESULTS
  Delta height SDS over 2 years of therapy was significantly higher in Group 1 (1.1 +/- 1.0) than in Group 2 (0.7 +/- 0.6) (p <0.05) in spite of a significantly lower dose of GH (14.6 +/- 3.3 in Group 1 vs 17.0 +/- 3.1 IU/m2/week in Group 2, p < 0.05). Ht--MPH SDS showed an increase from -2.4 +/- 1.7 to -1.4 +/- 1.5 in Group 1 and from -1.5 +/- 1.5 to -0.8 +/- 1.3 in Group 2. Overall delta height SDS showed negative correlations with age (r = -0.32), height SDS (r = -0.41) and height--MPH SDS (r = -0.40) at onset of therapy (p < 0.001).
  
  
  CONCLUSIONS
  These data show that in IGHD the slight increase (15-20%) in the dose of GH during puberty was not adequate to maintain height velocity at the same magnitude as in prepuberty, and thus was not cost effective.
authors.affiliation: Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. feyzad@istanbul.edu.tr
authors.forename: F
authors.initials: F
authors.lastname: Darendeliler
authors.forename: M
authors.initials: M
authors.lastname: Berberoğlu
authors.forename: G
authors.initials: G
authors.lastname: Ocal
authors.forename: P
authors.initials: P
authors.lastname: Adiyaman
authors.forename: R
authors.initials: R
authors.lastname: Bundak
authors.forename: H
authors.initials: H
authors.lastname: Günöz
authors.forename: F
authors.initials: F
authors.lastname: Baş
authors.forename: S
authors.initials: S
authors.lastname: Darcan
authors.forename: D
authors.initials: D
authors.lastname: Gökşen
authors.forename: I
authors.initials: I
authors.lastname: Arslanoğlu
authors.forename: M
authors.initials: M
authors.lastname: Yildiz
authors.forename: O
authors.initials: O
authors.lastname: Ercan
authors.forename: G
authors.initials: G
authors.lastname: Ercan
authors.forename: E
authors.initials: E
authors.lastname: Ozerkan
authors.forename: S
authors.initials: S
authors.lastname: Can
authors.forename: E
authors.initials: E
authors.lastname: Böber
authors.forename: E
authors.initials: E
authors.lastname: Adal
authors.forename: S
authors.initials: S
authors.lastname: Sarikaya
authors.forename: Y
authors.initials: Y
authors.lastname: Dallar
authors.forename: Z
authors.initials: Z
authors.lastname: Siklar
authors.forename: I
authors.initials: I
authors.lastname: Bircan
authors.forename: A
authors.initials: A
authors.lastname: Bideci
authors.forename: B
authors.initials: B
authors.lastname: Yüksel
authors.forename: A
authors.initials: A
authors.lastname: Büyükgebiz
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004393:Dwarfism, Pituitary / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011627:Puberty; D014421:Turkey
chemical_list: D019382:Human Growth Hormone; D013006:Growth Hormone