title: Constitutional delay influences the auxological response to growth hormone treatment in children with short stature and growth hormone sufficiency.
abstract: In a retrospective, population based cohort study, we examined whether constitutional delay was associated with the growth response to growth hormone (GH) in children with short stature and normal GH responses. 70 patients were treated with 21 GH iu/m2/week from 1975 to 2013 throughout New Zealand. Demographic and auxological data were prospectively collected and standard deviation scores (SDS) were calculated for height (HtSDS), yearly growth velocity (GV-SDS), body mass index (BMI-SDS) and predicted adult height (PAH-SDS) at time of the last available bone age. In the first year, GH was associated with marked increase in HtSDS (+0.46 (0.19, 0.76), p < 0.001) and GV-SDS (from -1.9 (-3.6, -0.7) to +2.7 (0.45, 4.2), p < 0.001). The increase in HtSDS but not in GV-SDS was greatest with younger patients and greater bone age delay, with no effect of sex, BMI-SDS or baseline HtSDS. PAH-SDS increased with treatment (+0.94 (0.18, 1.5)); increased PAH-SDS was associated with less bone age delay and greater initial increase in HtSDS. This study shows that greater bone age delay was associated with greater initial improvement in height but less improvement in predicted adult heights, suggesting that children with very delayed bone ages may show accelerated maturation during GH treatment.
authors.affiliation: 1] Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland [2] Clinical Endocrinology Group, Liggins Institute, University of Auckland.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Gunn
authors.affiliation: Clinical Endocrinology Group, Liggins Institute, University of Auckland.
authors.forename: Wayne S
authors.initials: WS
authors.lastname: Cutfield
authors.affiliation: Clinical Endocrinology Group, Liggins Institute, University of Auckland.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hofman
authors.affiliation: Paediatric Endocrinology Service, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Jefferies
authors.affiliation: Clinical Endocrinology Group, Liggins Institute, University of Auckland.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Albert
authors.affiliation: 1] Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland [2] Clinical Endocrinology Group, Liggins Institute, University of Auckland.
authors.forename: Alistair J
authors.initials: AJ
authors.lastname: Gunn
mesh_terms: D000328:Adult; D000365:Age Determination by Skeleton; D001827:Body Height / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004392:Dwarfism / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand; D012189:Retrospective Studies
chemical_list: D013006:Growth Hormone