title: A comparison of different definitions of growth response in short prepubertal children treated with growth hormone.
abstract: BACKGROUND
  How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial.
  
  
  OBJECTIVE
  Assess various criteria of poor response.
  
  
  METHODS
  Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) ≤-2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS -3.2.
  
  
  RESULTS
  Median [25-75 percentile] first-year gain in Ht SDS was 0.65 (0.40-0.90) and height velocity (HtV) 8.67 (7.51-9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 μg/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5.
  
  
  CONCLUSIONS
  Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden. peter.bang@ki.se
authors.forename: P
authors.initials: P
authors.lastname: Bang
authors.forename: R
authors.initials: R
authors.lastname: Bjerknes
authors.forename: J
authors.initials: J
authors.lastname: Dahlgren
authors.forename: L
authors.initials: L
authors.lastname: Dunkel
authors.forename: J
authors.initials: J
authors.lastname: Gustafsson
authors.forename: A
authors.initials: A
authors.lastname: Juul
authors.forename: B
authors.initials: B
authors.lastname: Kriström
authors.forename: P
authors.initials: P
authors.lastname: Tapanainen
authors.forename: V
authors.initials: V
authors.lastname: Aberg
mesh_terms: D054316:Biomarkers, Pharmacological / Q000032:analysis; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011379:Prognosis; D011627:Puberty / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D054316:Biomarkers, Pharmacological; D019382:Human Growth Hormone