title: Growth hormone dose-dependent pubertal growth: a randomized trial in short children with low growth hormone secretion.
abstract: OBJECTIVE
  Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i.e. idiopathic isolated GH deficiency.
  
  
  METHODS
  A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH 33 µg/kg/day for ≥1 year. They were randomized to receive 67 µg/kg/day (GH(67)) given as one (GH(67×1); n = 35) or two daily injections (GH(33×2); n = 36), or to remain on a single 33 µg/kg/day dose (GH(33×1); n = 40). Growth was assessed as heightSDSgain for prepubertal, pubertal and total periods, as well as AHSDS versus the population and the midparental height.
  
  
  RESULTS
  Pubertal heightSDSgain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33×1), 0.41, p < 0.05). AHSDS was greater on GH(67) (GH(67×1), -0.84; GH(33×2), -0.83) than GH(33) (-1.25, p < 0.05), and heightSDSgain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target heightSDS.
  
  
  CONCLUSIONS
  Pubertal heightSDSgain and AHSDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once- and twice-daily GH(67) regimens. © 2014 S. Karger AG, Basel.
authors.affiliation: Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Albertsson-Wikland
authors.forename: Berit
authors.initials: B
authors.lastname: Kriström
authors.forename: Elena
authors.initials: E
authors.lastname: Lundberg
authors.forename: A Stefan
authors.initials: AS
authors.lastname: Aronson
authors.forename: Jan
authors.initials: J
authors.lastname: Gustafsson
authors.forename: Lars
authors.initials: L
authors.lastname: Hagenäs
authors.forename: Sten-A
authors.initials: SA
authors.lastname: Ivarsson
authors.forename: Björn
authors.initials: B
authors.lastname: Jonsson
authors.forename: Martin
authors.initials: M
authors.lastname: Ritzén
authors.forename: Torsten
authors.initials: T
authors.lastname: Tuvemo
authors.forename: Ulf
authors.initials: U
authors.lastname: Westgren
authors.forename: Otto
authors.initials: O
authors.lastname: Westphal
authors.forename: Jan
authors.initials: J
authors.lastname: Aman
mesh_terms: D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006128:Growth; D006130:Growth Disorders / Q000378:metabolism*; D013006:Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000172:deficiency / Q000378:metabolism* / Q000627:therapeutic use*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011627:Puberty; D012727:Sex Characteristics
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone