GH responsiveness in a large multinational cohort of SGA children with short stature (NESTEGG) is related to the exon 3 GHR polymorphism.
OBJECTIVE
The polymorphic deletion of exon 3 of the GH receptor (d3-GHR) has recently been linked to the magnitude of growth response to recombinant human GH (rhGH) therapy in short children with or without GH deficiency. We investigated this association in a large multinational cohort from the Network of European Studies of Genes in Growth (NESTEGG), comprising short children born small for gestational age (SGA).


METHODS
The study included short prepubertal SGA children treated with rhGH for 1 or 2 years.


METHODS
Two hundred and forty white Caucasian SGA children (138 male, 102 female) aged 6.6 +/- 2.3 years with a height at -3.0 +/- 0.7 SDS at start of rhGH treatment; 193 ethnically matched controls.


METHODS
The GHR polymorphism (fl/fl, fl/d3 or d3/d3) was genotyped by polymerase chain reaction (PCR) multiplex assay. Growth velocity (G/V) in cm/year and changes in GV during the first and second year of rhGH treatment were evaluated.


RESULTS
The change in GV was significantly greater in SGA children carrying one or two copies of the d3-GHR allele (P = 0.038 for the first year and P = 0.041 for the second year of GH treatment), but the change in height was not significantly different. Birthweight was significantly lower in SGA children with the d3/d3 genotype than in SGA children with the fl/fl genotype (P = 0.034) and in those with the fl/d3 genotype (P = 0.016).


CONCLUSIONS
Our data, based on a large cohort, showed that the exon 3 GHR polymorphism is associated with responsiveness to rhGH treatment in SGA children with short stature.
Tauber
M
M
Division of Endocrinology, Genetics, Gynaecology and Bone Diseases, Hôpital des Enfants, Toulouse, France. molinas.c@chu-toulouse.fr
Ester
W
W
Auriol
F
F
Molinas
C
C
Fauvel
J
J
Caliebe
J
J
Nugent
T
T
Fryklund
L
L
Ranke
M B
MB
Savage
M O
MO
Clark
A J L
AJ
Johnston
L B
LB
Hokken-Koelega
A C S
AC
D001827:Body Height / Q000187:drug effects* / Q000235:genetics*; D002352:Carrier Proteins / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004351:Drug Resistance / Q000235:genetics; D005091:Exons / Q000235:genetics; D005260:Female; D005838:Genotype; D006130:Growth Disorders / Q000188:drug therapy* / Q000235:genetics*; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development; D038622:Internationality; D008297:Male; D010641:Phenotype; D011110:Polymorphism, Genetic / Q000235:genetics; D016896:Treatment Outcome
D002352:Carrier Proteins; D019382:Human Growth Hormone; C051815:somatotropin-binding protein