GROWTH-HORMONE TREATMENT IN GROWTH HORMONE-SUFFICIENT AND HORMONE-INSUFFICIENT CHILDREN WITH INTRAUTERINE GROWTH RETARDATION RUSSELL-SILVER-SYNDROME/

Fifty-eight short prepubertal children with IUGR received GH treatment (mean dose: 28 IU/m(2)/week) for a mean (SEM) period of time of 3.4 ( 0.13) years (range 1-4 years). They were subdivided according to their GH response to a pharmacological test. Twenty-six were GH insufficien t (GHI) (group 1) and 32 were non-GHI (group 2), At the commencement o f GH therapy mean chronological age was 6.1 (0.4) years in both groups , mean height SDS (SEM) was -3.5 (0.2) in group 1 and -3.6 (0.2) in gr oup 2, mean growth velocity (GV) SDS (SEM) was -1.9 (0.3) in group 1 a nd -0.3 (0.2) in group 2, GH therapy induced significant growth accele ration throughout the follow-up period without any significant differe nces between the two groups. GV SDS (SEM) increased to +3.0 (0.5) in g roup 1 and to +3.7 (0.4) in group 2 (p < 0.05 compared to baseline) du ring the first year of therapy. Subsequently, the growth-promoting eff ects of CH therapy diminished with time but GV remained significantly higher than baseline. This growth enhancement produced a significant r ise in height SDS (SEM) reaching -1,4 (0.2) in group 1 and -1,7 (0.2) in group 2 after 4 years. In conclusion, our data did not show any sig nificant differences in the growth response to GH therapy between GH-s ufficient and -insufficient IUGR children who were only distinguishabl e by their GH secretion. This indicates that the decision to treat a s hort IUGR child with GH therapy should not be based upon the GH respon se to a provocative test.