Response of Indian growth hormone deficient children to growth hormone therapy: association with pituitary size.
OBJECTIVE
To ascertain the impact of pituitary size as judged by Magnetic Resonance Imaging (MRI), on response to Growth Hormone (GH) therapy in GH deficient children.


METHODS
Thirty nine children (9.1 ± 2.7 y, 22 boys) with non-acquired GH deficiency (21 Isolated GH deficiency and 18 Combined pituitary hormone deficiency) were consecutively recruited and followed up for one year. Clinical, radiological (bone age and MRI) and biochemical parameters were studied.


RESULTS
Children with hypoplastic pituitary (pituitary height < 3 mm) had more severe height deficit (height for age Z-score -6.0 vs. -5.0) and retardation of skeletal maturation (bone age chronological age ratio of 0.59 vs. 0.48) at baseline as compared to children with normal pituitary heights (p < 0.05 for both). After one year of GH therapy, height for age Z scores and percentage change in height for age Z scores were significantly higher in children with hypoplastic pituitaries (13.8 ± 3.6 and 28.7 % vs. 11.2 ± 4.1 and 21.4 %). Significant co-relation was observed between pituitary height and height for age Z-scores at baseline (r = 0.39, p < 0.05). The predicted adult height using Tanner Whitehouse-2 equations improved from 140.8 to 152.3 cm in children with hypoplastic pituitary when compared to an increase from 145.8 to 153.5 cm observed in children with normal pituitary height (p < 0.05).


CONCLUSIONS
Indian growth hormone deficient children with hypoplastic pituitary respond better to therapy with GH in short term.
Department of Growth and Pediatric Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
Vaman V
VV
Khadilkar
Hemchand Krishna
HK
Prasad
Veena H
VH
Ekbote
Vaishakhi T
VT
Rustagi
Joshita
J
Singh
Shashi A
SA
Chiplonkar
Anuradha V
AV
Khadilkar
D000328:Adult; D002648:Child; D004393:Dwarfism, Pituitary / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D006128:Growth / Q000187:drug effects*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007194:India; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000002:abnormalities* / Q000503:physiopathology; D011446:Prospective Studies
D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone