Semra Çetinkaya1, Şükran Poyrazoğlu2, Firdevs Baş2, Oya Ercan3, Metin Yıldız4, Erdal Adal5, Abdullah Bereket6, Saygın Abalı6, Zehra Aycan7,8, Şenay Savaş Erdeve1, Merih Berberoğlu9, Zeynep Şıklar9, Meltem Tayfun10, Şükran Darcan11, Eda Mengen12, İffet Bircan13, Filiz Mine Çizmecioğlu Jones14, Enver Şimşek15, Esra Deniz Papatya16, Mehmet Nuri Özbek17, Semih Bolu18, Ayhan Abacı19, Muammer Büyükinan20, Feyza Darendeliler2. 1. Health Sciences University, Dr Sami Ulus Obstetrics and Gynecology, Children's Health and Disease, Health Implementation and Research Center, Department of Pediatric Endocrinology, Ankara, Turkey. 2. Istanbul University, Faculty of Medicine, Institute of Child Health, Department of Pediatric Endocrinology, Istanbul, Turkey. 3. Istanbul University, Cerrahpasa Medical Faculty, Department of Pediatric Endocrinology, Istanbul, Turkey. 4. Göztepe Training and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey. 5. Istanbul Medipol University, Department of Pediatric Endocrinology, Istanbul, Turkey. 6. Marmara University, Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey. 7. Dr Sami Ulus Obstetrics and Gynecology, Children's Health and Disease Training and Research Hospital, Department of Pediatric Endocrinology, Ankara, Turkey. 8. Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey. 9. Ankara University School of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey. 10. Ankara Children's Hematology and Oncology Research and Training Hospital, Department of Pediatric Endocrinology, Ankara, Turkey. 11. Ege University, Faculty of Medicine, Department of Pediatric Endocrinology, Izmir, Turkey. 12. Cukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey. 13. Akdeniz University Faculty of Medicine, Department of Pediatric Endocrinology, Antalya, Turkey. 14. Kocaeli University, Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey. 15. Osmangazi University Faculty of Medicine, Department of Pediatric Endocrinology, Eskişehir, Turkey. 16. Bakırköy Dr Sadi Konuk Education and Research Hospital, Clinics of Pediatric Endocrinology, İstanbul, Turkey. 17. Health Sciences University, Gazi Yaşargil Education and Training Hospital, Clinics of Pediatric Endocrinology, Diyarbakır, Turkey. 18. Düzce University, Faculty of Medicine, Department of Pediatric Endocrinology, Konuralp, Düzce, Turkey. 19. Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey. 20. Konya Education and Research Hospital, Clinics of Pediatric Endocrinology, Konya, Turkey.
Abstract
BACKGROUND: The aim of the study was to assess the response to growth hormone (GH) treatment in very young patients with GH deficiency (GHD) through a national, multi-center study. Possible factors affecting growth response were assessed (especially mini-puberty). METHODS: Medical reports of GHD patients in whom treatment was initiated between 0 and 3 years of age were retrospectively evaluated. RESULTS: The cohort numbered 67. The diagnosis age was 12.4±8.6 months, peak GH stimulation test response (at diagnosis) as 1.0±1.4 ng/mL. The first and second years length gain was 15.0±4.3 and 10.4±3.4 cm. Weight gain had the largest effect on first year growth response; whereas weight gain and GH dose were both important factors affecting second year growth response. In the multiple pituitary hormone deficiency (MPHD) group (n=50), first year GH response was significantly greater than in the isolated GH deficiency (IGHD) group (n=17) (p=0.030). In addition first year growth response of infants starting GH between 0 and 12 months of age (n=24) was significantly greater than those who started treatment between 12 and 36 months of age (n=43) (p<0.001). These differences were not seen in the second year. Δ Length/height standard deviation score (SDS), Δ body weight SDS, length/height SDS, weight SDS in MPHD without hypogonadism for the first year of the GH treatment were found as significantly better than MPHD with hypogonadism. CONCLUSIONS: Early onsets of GH treatment, good weight gain in the first year of the treatment and good weight gain-GH dose in the second year of the treatment are the factors that have the greatest effect on length gain in early onset GHD. The presence of the sex steroid hormones during minipubertal period influence growth pattern positively under GH treatment (closer to the normal percentage according to age and gender).
BACKGROUND: The aim of the study was to assess the response to growth hormone (GH) treatment in very young patients with GH deficiency (GHD) through a national, multi-center study. Possible factors affecting growth response were assessed (especially mini-puberty). METHODS: Medical reports of GHD patients in whom treatment was initiated between 0 and 3 years of age were retrospectively evaluated. RESULTS: The cohort numbered 67. The diagnosis age was 12.4±8.6 months, peak GH stimulation test response (at diagnosis) as 1.0±1.4 ng/mL. The first and second years length gain was 15.0±4.3 and 10.4±3.4 cm. Weight gain had the largest effect on first year growth response; whereas weight gain and GH dose were both important factors affecting second year growth response. In the multiple pituitary hormone deficiency (MPHD) group (n=50), first year GH response was significantly greater than in the isolated GH deficiency (IGHD) group (n=17) (p=0.030). In addition first year growth response of infants starting GH between 0 and 12 months of age (n=24) was significantly greater than those who started treatment between 12 and 36 months of age (n=43) (p<0.001). These differences were not seen in the second year. Δ Length/height standard deviation score (SDS), Δ body weight SDS, length/height SDS, weight SDS in MPHD without hypogonadism for the first year of the GH treatment were found as significantly better than MPHD with hypogonadism. CONCLUSIONS: Early onsets of GH treatment, good weight gain in the first year of the treatment and good weight gain-GH dose in the second year of the treatment are the factors that have the greatest effect on length gain in early onset GHD. The presence of the sex steroid hormones during minipubertal period influence growth pattern positively under GH treatment (closer to the normal percentage according to age and gender).
Authors: Leda L Ferreira; Juan P Aguilar Ticona; Paulo S Silveira-Mattos; María B Arriaga; Thaisa B Moscato; Gildásio C Conceição; Antonio Carlos Dos Santos; Federico Costa; Crésio A D Alves; Sonir R Antonini Journal: JAMA Netw Open Date: 2021-05-03