Effect of growth hormone therapy on Taiwanese children with growth hormone deficiency

Abstract

Human growth hormone (GH) has been successfully used in children with GH deficiency (GHD). However, there are few published data on the effect of GH in Taiwanese children with GHD. Methods: We performed a retrospective cohort study to identify factors influencing the effect of GH therapy on ethnic Chinese children with GHD in Taiwan. Idiopathic GHD can be classified into isolated GHD (IGHD) and multiple pituitary hormone deficiency (MPHD). The study looked at the effect of GH on the auxological, biochemical, and imaging parameters of 51 patients (13 girls and 38 boys) in three different diagnostic groups: MPHD (n = 12), IGHD (n = 8), and transient GHD (TGHD; n = 31). TGHD is defined as a GH peak >10 μg/L in re-evaluation by two GH stimulation tests approximately 6 months after discontinuation of GH therapy. Results: The height velocity for first-year GH therapy was 7.61 ± 1.46, 8.14 ± 1.92, and 9.99 ± 2.75 cm/y in the TGHD, IGHD, and MPHD groups, respectively. After post hoc comparison, the MPHD group had a significantly accelerated height velocity in the first year compared to the TGHD group. Correlation analysis showed that a change in height standard deviation score (SDS) in the first year had a significant negative correlation with the following variables: peak GH (r = −0.52, p < 0.001), pretreatment height SDS (r = −0.49, p < 0.001), and height-target height (Ht-TH) SDS (r = −0.49, p < 0.001). Change in height SDS in the first 2 years had a significantly negative correlation with peak GH (r = −0.51, p < 0.001), insulin-like growth factor-1 SDS (r = −0.35, p = 0.022), height SDS (r = −0.60, p < 0.001), difference between bone age and chronological age (r = −0.46, p = 0.001), and Ht-TH SDS (r = −0.50, p = 0.001). After using multiple linear regression, the pretreatment GH peak value was found to be significantly associated with height increments after 1 year of GH treatment (B = −0.07, p = 0.014). Conclusion: The administration of GH to children with GHD results in a pronounced acceleration in linear growth during the first year of treatment, especially in those with MPHD. The diagnosis of GHD requires comprehensive auxological, biochemical, and brain magnetic resonance imaging assessment. We also suggest that patients with GHD, specifically IGHD, must undergo a re-evaluation of GH secretion after completion of GH therapy.

Keywords

• growth hormone deficiency
• growth hormone therapy
• isolated growth hormone deficiency
• multiple pituitary hormone deficiency
• transient growth hormone deficiency