BODY-MASS INDEX IN GROWTH-HORMONE DEFICIENT CHILDREN BEFORE AND DURING GROWTH-HORMONE TREATMENT

Growth hormone deficiency (GHD) is associated with truncal obesity. We aimed at identifying factors that determine the body mass index (BMI) of untreated GHD children and the changes in BMI during 2 years of GH therapy in 348 Dutch GHD children registered in the National GH Regis tration Database. BMI was expressed as a standard deviation score (SDS ). Before GH therapy, the mean (95% CI) BMI-SDS in all GHD children (0 .09 (-0.05 to 0.24) SDS) was comparable to normal children. Patients w ith GHD due to a cranial tumour have a higher BMI (1.03 (0.69-1.36) SD S; p < 0.0001) as well as those with multiple pituitary hormone defici encies (0.35 (0.14-0.57) SDS; p = 0.005) and patients who are in puber ty at start of GH therapy (0.60 (0.13-1.08) SDS; p = 0.036). During GH therapy BMI initially decreased to reach a nadir of -0.28 (-0.35 to - 0.21) SDS at 6 months. Thereafter BMI progressively increased to -0.09 (-0.18 to -0.04) SDS after 24 months. A higher initial BMI-SDS result ed in a larger decrease in BMI-SDS. We showed that this can be suffici ently explained by a regression to the mean effect.