Factors Affecting on Final Adult Height and Total Height Gain in Children with Idiopathic and Organic Growth Hormone Deficiency after Growth Hormone Treatment

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the factors affecting the final adult height and total height gain in idiopathic and organic growth hormone deficient(GHD) children after growth hormone(GH) treatment. METHODS: Thirteen patients with idiopathic GHD and 22 patients with organic GHD who had been treated with GH and attained adult final height were included in this study. Factors which could affect the final adult height(FAH) and total height gain, were evaluated. RESULTS: Height SDS(standard deviation score) at initial GH treatment in idiopathic GHD was significantly shorter than that in organic GHD(-4.13+/-1.28 vs -1.66+/-1.06, P<0.001). Growth velocity during the first year of GH treatment was 9.69+/-3.19 cm(idiopathic GHD) and 7.87+/-3.65 cm(organic GHD). Height(SDS) at puberty in organic GHD was significantly greater than in idiopathic GHD (-0.55+/-1.25 vs -2.28+/-0.95, P<0.001). Final adult height(SDS) was significantly greater in organic GHD than in idiopathic GHD(0.22+/-1.06 vs -1.44+/-0.84, P<0.001). In idiopathic GHD, total height gain (SDS) was most significantly correlated with midparental height minus initial height(MPH-IH)(SDS) (r=0.886, P<0.001). Total height gain(SDS) was more significantly correlated with MPH-IH(SDS) and prepubertal height gain(SDS) in idiopathic GHD(r=0.640, P=0.01, r=0.801, P<0.001). CONCLUSION: Final adult height was greater in organic GHD than in idiopathic GHD patients. While total height gain(SDS) was more pronounced in children with lower initial height compared to MPH, absolute final adult height was influenced by height at puberty. To improve the final adult height in children with GHD, height at onset of puberty must be increased by early diagnosis and continuous treatment with optimal doses of GH. There results should be evaluated with more patients.