Differential growth and maturation in idiopathic growth-hormone-deficient children

This study describes and compares the growth and maturation of idiopathic growth hormone deficiency (IGHD) and evaluates the potential effects of growth hormone therapy. The sample includes 40 idiopathic growth-hormone-deficient children grouped according to duration of growth hormone replacement therapy. Somatic and craniofacial development, skeletal maturation and dental maturation were evaluated and compared. The results showed consistent delays in the maturity indices for IGHD children. Height age displayed the greatest delay (3 years) followed by skeletal age (2.2 years) and dental age (0.8 years). Overall craniofacial growth deficiencies were also demonstrated. Anterior cranial base and mandibular length were most affected; posterior cranial base length and facial heights were least affected. Analysis of covariance, controlling for the starting age of therapy, showed significant differences between children grouped according to duration of growth hormone therapy. Catch-up growth with hormonal therapy was established for height, facial height, skeletal age and posterior cranial base length. It was concluded that the various craniofacial skeletal components have different potentials for growth retardation with IGHD; catch-up growth following growth hormone replacement therapy was greatest for the components with the greatest initial (or baseline) growth potential.