Paolo Cavarzere1, Rossella Gaudino1,2, Marco Sandri3, Diego Alberto Ramaroli1, Angelo Pietrobelli1,2, Marco Zaffanello1,2, Alessandra Guzzo4, Gian Luca Salvagno4, Giorgio Piacentini1,2, Franco Antoniazzi1,2,5. 1. Pediatric Division, Department of Pediatrics, University Hospital of Verona, Verona, Italy. 2. Pediatric Clinic, Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy. 3. Data Methods and Systems Statistical Laboratory, University of Brescia, Brescia, Italy. 4. Laboratory Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. 5. Regional Center for the Diagnosis and Treatment of Children and Adolescents Rare Skeletal Disorders, Pediatric Clinic, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
Abstract
OBJECTIVES: To report the frequency and characteristics of growth hormone (GH) deficiency (GHD) in adolescents who had normalized GH secretion at mid-puberty and to identify possible factors predictive for GH sufficiency at puberty. DESIGN: Clinical analysis of children affected by GHD at five time points: diagnosis; first year of therapy; intermediate stage of puberty; retesting and end of growth phase. METHODS: The study population was 80 children with idiopathic GHD and treated with GH for at least 2 years. Treatment was discontinued at the intermediate stage of puberty. Retesting with an arginine test was performed 12 weeks later. If GH peak at retesting was ≥8 μg/L, the therapy was definitively discontinued, otherwise it was restarted and continued until achievement of near-final height. RESULTS: GH therapy was discontinued in 44 children (55%), and restarted in 36 (45%). No evidence of differences in definitive height and in the delta height between the genetic target and the definitive height was found between the two groups. The only predictive factor for GHD at mid-puberty was the insulin growth factor-1 (IGF-1) level at 1 year of GH treatment. CONCLUSIONS: GH secretion should be retested at mid-puberty. Retesting at puberty may reduce potential side effects and minimize costs, without impairing growth potential and final height.
OBJECTIVES: To report the frequency and characteristics of growth hormone (GH) deficiency (GHD) in adolescents who had normalized GH secretion at mid-puberty and to identify possible factors predictive for GH sufficiency at puberty. DESIGN: Clinical analysis of children affected by GHD at five time points: diagnosis; first year of therapy; intermediate stage of puberty; retesting and end of growth phase. METHODS: The study population was 80 children with idiopathic GHD and treated with GH for at least 2 years. Treatment was discontinued at the intermediate stage of puberty. Retesting with an arginine test was performed 12 weeks later. If GH peak at retesting was ≥8 μg/L, the therapy was definitively discontinued, otherwise it was restarted and continued until achievement of near-final height. RESULTS: GH therapy was discontinued in 44 children (55%), and restarted in 36 (45%). No evidence of differences in definitive height and in the delta height between the genetic target and the definitive height was found between the two groups. The only predictive factor for GHD at mid-puberty was the insulin growth factor-1 (IGF-1) level at 1 year of GH treatment. CONCLUSIONS: GH secretion should be retested at mid-puberty. Retesting at puberty may reduce potential side effects and minimize costs, without impairing growth potential and final height.
Authors: Paulo Francisco de Almeida-Neto; Paulo Moreira Silva Dantas; Vanessa Carla Monteiro Pinto; Tatianny de Macêdo Cesário; Nathália Monastirski Ribeiro Campos; Eduardo Estevan Santana; Dihogo Gama de Matos; Felipe J Aidar; Breno Guilherme de Araújo Tinoco Cabral Journal: Int J Environ Res Public Health Date: 2020-05-08 Impact factor: 3.390
Authors: Paulo Francisco de Almeida-Neto; Dihogo Gama de Matos; Vanessa Carla Monteiro Pinto; Paulo Moreira Silva Dantas; Tatianny de Macêdo Cesário; Luíz Felipe da Silva; Alexandre Bulhões-Correia; Felipe José Aidar; Breno Guilherme de Araújo Tinôco Cabral Journal: Int J Environ Res Public Health Date: 2020-08-05 Impact factor: 3.390