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Karger Publishers, Hormone Research in Paediatrics, 5(75), p. 335-345, 2011

DOI: 10.1159/000322878

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A Comparison of Different Definitions of Growth Response in Short Prepubertal Children Treated with Growth Hormone

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

<i>Background:</i> How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial. <i>Aim:</i> Assess various criteria of poor response. <i>Subjects and Methods:</i> Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) ≤–2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS –3.2. <i>Results:</i> Median [25–75 percentile] first-year gain in Ht SDS was 0.65 (0.40–0.90) and height velocity (HtV) 8.67 (7.51–9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 µg/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5. <i>Conclusion:</i> Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.