FINAL HEIGHT IN NONGROWTH HORMONE-DEFICIENT CHILDREN TREATED WITH GROWTH-HORMONE

OBJECTIVE To evaluate the final height of nongrowth hormone deficient (N-GHD) children treated with growth hormone (GH). DESIGN Multicentre retrospective study. PATIENTS 71 (54M/17F) N-GHD children (peak GH aft er pharmacological stimulation >14-24 mU/l) who had been treated for 4 .19 +/- 0.14 years with GH (0.69 +/- 0.02 IU/kg/week). MEASUREMENTS He ight(H) and height velocity (HV) expressed as standard deviation score (SDS) for chronological age (CA) and bone age (BA), BA/CA ratio, and predicted adult height (PAHSDS) were evaluated before and during treat ment, and at each pubertal stage, Target height (TH), and final height (FH) were also calculated, and expressed as SDS. RESULTS In the whole group, HSDS for CA increased significantly after the first year on GH , and remained significantly increased for 4 years. This did not occur to HSDS for BA, owing to a significant increase in BAI CA after the f irst year of therapy, In addition, this increase coincided with stages 4 and 5 of puberty, HVSDS for CA and BA also increased significantly after the first year of treatment, and remained significantly elevated for 4 years. PAHSDS did not change significantly during treatment, FH SDS (-1.69 +/- 0.07) was similar to PAHSDS (-1.6 +/- 0.12) and target height (THSDS) (-1.46 +/- 0.08), FHSDS was greater than or equal to TH SDS in 36.6% of the patients, and greater than or equal to initial PAH SDS in 34.5%. Male patients were subdivided into 2 groups (A and B), P atients in Group A (n = 26) started treatment at puberty, while group B (n = 28) consisted of subjects who started therapy during prepuberta l years. Height, height velocity and predicted adult height showed the same pattern as in the whole group, in each subgroup, BA/CA advanced significantly in group A after the second year on GH and in group B, a fter at least 3 years of therapy, FHSDS, THSDS, and PAHSDS were simila r in both groups (-1.7 +/- 0.13, -1.29 +/- 0.2 and -1.39 +/- 0.15 in g roup A and -1.48 +/- 0.11, -1.85 +/- 0.15 and -1.36 +/- 0.12 in group B, respectively). However, in group B (prepubertal), FHSDS was greater than or equal to initial PAHSDS in 60% of the patients and greater th an or equal to THSDS in 40.7%, while in group A (pubertal), FHSDS was greater than or equal to initial PAHSDS only in 22.7% of the patients and greater than or equal to THSDS in 34.6%, FHSDS was found to be cor related with THSDS, PAHSDS at the onset of treatment, and after 1 year of treatment, The age at the beginning of puberty, and the duration o f puberty were appropriate in all groups. CONCLUSIONS GH treatment was effective in increasing height velocity of short non-GH-deficient chi ldren, but final height was not definitely improved with respect to in itial predicted adult height.