Growth Hormone Dose-Dependent Pubertal Growth: A Randomized Trial in Short Children with Low Growth Hormone Secretion

Research output: Contribution to journalArticle

Abstract

Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency. Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height. Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS. Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.

Details

Authors
  • Kerstin Albertsson-Wikland
  • Berit Kristrom
  • Elena Lundberg
  • A. Stefan Aronson
  • Jan Gustafsson
  • Lars Hagenas
  • Sten Ivarsson
  • Bjorn Jonsson
  • Martin Ritzen
  • Torsten Tuvemo
  • Ulf Westgren
  • Otto Westphal
  • Jan Aman
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics
  • Endocrinology and Diabetes

Keywords

  • Gain in height, Prepubertal growth, Growth hormone frequency, Delayed, infancy-childhood transition, Puberty
Original languageEnglish
Pages (from-to)158-170
JournalHormone Research in Paediatrics
Volume82
Issue number3
StatePublished - 2014
Publication categoryResearch
Peer-reviewedYes