Prediction of height velocity of prepubertal children with growth hormone deficiency in the first year of treatment with recombinant human growth hormone
V. Mueller et al., Prediction of height velocity of prepubertal children with growth hormone deficiency in the first year of treatment with recombinant human growth hormone, J PED END M, 13(7), 2000, pp. 893-897
Aim: Several methods have been developed to predict the outcome of growth h
ormone (GH) therapy in children with growth hormone deficiency (GHD).
Methods: Over 50 factors for each of 92 prepubertal patients with GHD (26 p
atients with total and 45 patients with partial GHD, 21 patients with neuro
secretory dysfunction) were collected and included in multiple regression a
nalyses and other nonlinear models to predict height velocity (HV) (cm/yr)
in the first year of treatment. Afterwards the model was validated by two o
ther cohorts of patients from other universities, which followed the same t
reatment regime as our clinic.
Results: Twelve parameters had a significant correlation to HV (p<0.05) and
a coefficient of determination >20%, Two parameters (ln BA, in GHmax) show
ed a coefficient of determination >60% for children with GHD in multiple re
gression analysis, The validation of the mathematical model against another
data set showed different results. GH was measured by the same method, but
BA was scored at the first clinic as in our clinic by only one doctor and
in the other university by several radiologists. The accuracy of prediction
in the first clinic was significantly higher than in the other university.
Conclusion: This model demonstrates that exact scoring of BA and precise me
asurement of GHmax in the stimulation test is necessary, and if carried out
carefully leads to useful prediction values for determining height velocit
y.