ADULT HEIGHT IN GROWTH-HORMONE (GH)-DEFICIENT CHILDREN TREATED WITH BIOSYNTHETIC GH

Near-adult height (AH) was determined in 121 children (72 males and 49 females) with GH deficiency (GHD) who were prepubertal when they bega n treatment with recombinant DNA-derived preparations of human GH. AH as a so score was -0.7 +/- 1.2 (mean +/- SD), significantly greater th an the pretreatment height sn score (-3.1 +/- 1.2), the predicted AH s o score (-2.2 +/- 1.2; Bayley-Pinneau method), and the height SD score at the start of puberty (-1.9 +/- 1.3). In contrast to studies of GH treatment outcome, which used pituitary-derived GH (pit-GH) in lower d oses, we found that males did not have a higher AH so score than femal es, spontaneous puberty did not diminish AH, and AH was significantly greater than that predicted at the start of GH treatment. In a multipl e regression equation, the statistically significant variables (all P < 0.0001) related to AH (r(2) = 0.70) were the following: duration of treatment with GH, sex (males were taller than females, as expected fo r the normal population), age (younger children had a greater AH) and height at the start of GH, and growth rate during first year of GH. Fo r the AH so score (r(2) = 0.47), pretreatment predicted AH, duration o f GH, and bone age delay were significant (P < 0.0002) explanatory var iables. Bone age delay (chronological age - bone age) had a negative i mpact on the AH Sn score. Target height, etiology of GHD, previous tre atment with pituitary GH, and the presence or absence of spontaneous p uberty did not significantly improve the prediction of AH. Early diagn osis of GHD and continuous treatment with larger doses of GH to near A H should improve the outcome in children with short stature due to GHD .