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New insights into factors influencing adult height in short SGA children: Results of a large multicentre growth hormone trial
Author(s) -
Renes J.S.,
Willemsen R.H.,
Mulder J.C.,
Bakkervan Waarde W.M.,
Rotteveel J.,
Oostdijk W.,
Houdijk E.C.A.M.,
Westerlaken C.,
Noordam C.,
Verrijn Stuart A.A.,
Odink R.J.,
Ridder M.A.J.,
HokkenKoelega A.C.S.
Publication year - 2015
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12677
Subject(s) - medicine , growth hormone , endocrinology , growth velocity , weight gain , growth hormone treatment , hormone , body weight
Summary Background Growth hormone ( GH ) treatment is effective in improving adult height ( AH ) in short children born SGA . However, there is a wide variation in height gain, even after adjustment for predictive variables. It is therefore important to investigate new factors which can influence the response to GH . Objective To investigate the efficacy of GH treatment (1 mg/m 2/ day) in short SGA children on AH . To assess the relation between spontaneous catch‐up growth after birth and growth during puberty on the total height gain SDS to AH . Patients Longitudinal GH trial in 170 children. Results Median age at start of GH was 7·1 years and height −3·0 SDS . AH was −1·8 SDS ( TH ‐corrected AH −1·1 SDS ) in boys and −1·9 SDS ( TH ‐corrected AH −1·3 SDS ) in girls. Spontaneous catch‐up growth after birth was ≥0·5 SDS in 42% of children. In contrast to expectation, spontaneous catch‐up growth was negatively correlated with total height gain SDS during GH ( P = 0·009). During puberty, height SDS declined (−0·4 SDS in boys and −0·5 SDS in girls) resulting in a lower total height gain SDS than expected. Pubertal height gain was 25·5 cm in boys and 15·3 cm in girls, significantly lower compared to AGA children ( P < 0·001). At onset of puberty, BA for boys and girls was moderately advanced ( P = 0·02 and P < 0·001, respectively). Growth velocity was comparable to AGA children during the first two years of puberty, but thereafter significantly lower until reaching AH ( P < 0·001). Conclusion In contrast to our hypothesis, children with greater spontaneous catch‐up growth after birth show a lower total height gain SDS during GH . Height SDS declines from mid‐puberty, due to a marked early deceleration of growth velocity.