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Optimal final adult height achieved by low-dose recombinant human growth hormone therapy

Tansit Saengkaew
Tansit Saengkaew
, 
Suparb Aroonparkmongkol
Suparb Aroonparkmongkol
 et 
Suttipong Wacharasindhu
Suttipong Wacharasindhu
   | 30 avr. 2024
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Article Category: Original article
Publié en ligne: 30 avr. 2024
Pages: 53 - 60
DOI: https://doi.org/10.2478/abm-2024-0011
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© 2024 Tansit Saengkaew et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

FAH compared to height before rhGH treatment (A) and MPH (B). The data are presented as median ± IQR. *P < 0.05, **P < 0.005. FAH, final adult height; GH, growth hormone; GHD, growth hormone deficiency; IQR, interquartile range; MPH, mid-parental height; rhGH, recombinant human growth hormone; SDS, standard deviation score.
FAH compared to height before rhGH treatment (A) and MPH (B). The data are presented as median ± IQR. *P < 0.05, **P < 0.005. FAH, final adult height; GH, growth hormone; GHD, growth hormone deficiency; IQR, interquartile range; MPH, mid-parental height; rhGH, recombinant human growth hormone; SDS, standard deviation score.

Clinical characteristics before and after rhGH treatment categorized according to the GH status as complete vs. partial GHD

Overall (n = 40) Complete GHD (n = 20) Partial GHD (n = 20) P
Sex, n (%) 1.0
  Male 25 (62.5) 12 (60.0) 13 (65.0)
  Female 15 (37.5) 8 (40.0) 7 (35.0)
Baseline
Age (years) 8.9 (3.0) 9.6 (3.4) 8.2 (2.6) 0.1
Bone age (years)* 4.5 [3.0, 7.8] 7.0 [2.8, 9.0] 4.3 [3.3, 4.9] 0.4
Height SDS −2.13 (0.94) −2.30 (1.07) −1.96 (0.78) 0.3
Weight SDS −1.19 (1.35) −1.04 (1.50) −1.34 (1.21) 0.5
HV (cm/year)† 3.55 [3.00, 4.80] 3.30 [2.95, 4.08] 4.50 [3.18, 4.93] 0.1
MPH SD −0.49 (1.0) −0.16 (0.087) −0.83 (1.02) 0.03
Peak GH (ng/mL) 4.63 (2.98) 2.56 (1.80) 6.70 (2.44) <0.001*
IGF-1 SDS −0.97 (1.56) −1.12 (1.93) −0.83 (1.11) 0.6
IGFBP-3 SDS −0.79 (1.44) −1.08 (1.25) −0.51 (1.60) 0.3
MPHD, n (%) 10 (25.0) 9 (45.0) 1 (5.0) 0.01*
TSH deficiency 7 (17.5) 6 (30.0) 1 (5.0) 0.1
DI 7 (17.5) 6 (30.0) 1 (5.0) 0.1
ACTH deficiency 5 (12.5) 5 (25.0) 0 (0.0) 0.1
Hypogonadism 7 (17.5) 7 (35.0) 0 (0.0) 0.01*
MRI finding, n (%) 0.1
  Normal 21 (52.5) 9 (45.0) 12 (60.0)
  Abnormal 7 (17.5) 6 (30.0) 1 (5.0)
  Not performed 12 (30.0) 5 (25.0) 7 (35.0)
Age at puberty (years)† 12.8 [11.9, 13.8] 13.1 [12.5, 14.0] 12.0 [11.2, 13.3]
  Male 13.3 (1.7) 13.7 (2.2) 12.9 (0.9) 0.3
  Female 12.2 (1.5) 13.2 (0.8) 10.5 (0.8) <0.001*
rhGH treatment
Duration of treatment (years) 4.9 (3.3) 5.7 (3.2) 4.0 (3.3) 0.1
rhGH dosage (μg/kg/d)† 28.4 [21.3, 31.7] 26.6 [19.8, 29.1] 30.9 [28.0, 31.9] 0.02*
Discontinue rhGH
Age (years)† 15.3 [14.4, 16.0] 15.3 [14.9, 16.2] 15.3 [14.0, 16.0] 0.5
Bone age (years)† 14.4 [14.0, 16.0] 14.4 [14.0, 16.0] 14.5 [14.0, 15.0] 0.9
FAH (cm)
  Male 166.2 (5.9) 168.0 (6.0) 161.4 (1.8) 0.003
  Female 152.5 (6.1) 152.2 (7.2) 153.2 (2.8) 0.4
FAH SDS† −0.87 [–1.56, −0.14] −0.65 [–1.22, 0.70] −1.47 [–1.66, −0.78] 0.2
Height SDS gain (start-stop of rhGH) 1.43 (1.00) 1.62 (1.09) 0.91 (0.47) 0.1
FAH-MPH SDS −0.64 (1.38) −0.55 (1.7) −0.87 (1.76) 0.6

Proportion of retesting GH results categorized according to the GH status and hormonal deficiency

Persistent GHD (n = 11) Transient GHD (n = 13) P
GH status, n (%) 0.4
  Complete GHD 8 (53.3) 7 (46.7)
  Partial GHD 3 (33.3) 6 (66.7)
Hormonal defects, n (%) 0.002*
  Isolated GHD 3 (20.0) 12 (80.0)
  MPHD 8 (88.9) 1 (11.1)
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