Effect of growth hormone (GH) treatment on the near-final height of 1258 patients with idiopathic GH deficiency: Analysis of a large international database

被引:150
作者
Reiter, Edward O. [1 ]
Price, David A.
Wilton, Patrick
Albertsson-Wikland, Kerstin
Ranke, Michael B.
机构
[1] Tufts Univ, Childrens Hosp, Sch Med, Springfield, MA 01199 USA
[2] Royal Manchester Childrens Hosp, Dept Child Hlth, Manchester M27 4HA, Lancs, England
[3] Pfizer, S-19190 Stockholm, Sweden
[4] Univ Gothenburg, Pediat Growth Res Ctr, S-40439 Gothenburg, Sweden
[5] Univ Tubingen, Childrens Hosp, Pediat Endocrinol Sect, D-72076 Tubingen, Germany
关键词
D O I
10.1210/jc.2005-2284
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Treatment with GH has been used to correct the growth deficit in children with GH deficiency (GHD). Although successful in increasing height velocity, such treatment often falls short of helping patients achieve full genetic height potential. Objective: This study set out to analyze near-final height (FH) data from a cohort of GH-treated children with idiopathic GHD. Design, Setting, and Participants: Of 1258 evaluable patients in the Pfizer International Growth Database (KIGS) with GHD, 980 were of Caucasian origin, and 278 were of Japanese origin; 747 had isolated GHD (IGHD), and 511 had multiple pituitary hormone deficiencies (MPHD). Main Outcome Measures: Near-FH, relation to midparental height, and factors predictive of growth outcomes were the main outcome measures. Results: Median height SD scores (SDS) at the start of treatment were -2.4 (IGHD) and -2.9 ( MPHD) for Caucasian males and -2.6 (IGHD) and -3.4 (MPHD) for females, respectively; comparable starting heights were -2.9 (IGHD) and -3.6 (MPHD) for Japanese males and -3.3 (IGHD) and -4.0 (MPHD) for females, respectively. Corresponding near-adult height SDS after GH treatment were -0.8 (IGHD) and -0.7 (MPHD) for Caucasian males and -1.0 (IGHD) and -1.1 (MPHD) for females, respectively; and -1.6 (IGHD) and -1.9 (MPHD) for Japanese males and -2.1 (IGHD) and -1.8 (MPHD) for females, respectively. Differences between near-adult height and midparental height ranged between - 0.6 and - 0.2 SDS for the various groups, with the closest approximation to MPH occurring in Japanese males with MPHD. The first-year increase in height SDS and prepubertal height gain was highly correlated with total height gain, confirming the importance of treatment before pubertal onset. Conclusions: It is possible to achieve FH within the midparental height range in patients with idiopathic GHD treated from an early age with GH, but absolute height outcomes remain in the lower part of the normal range. Patients with MPHD generally had a slightly better long-term height outcome.
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页码:2047 / 2054
页数:8
相关论文
共 30 条
[1]  
August GP, 1998, PEDIATRICS, V102, P512
[2]   Tertiary alkaline volcanics in the Nunatak Region, Northeast Greenland: new observations and comparison with Siberian maymechites [J].
Bernstein, S ;
Leslie, AG ;
Higgins, AK ;
Brooks, CK .
LITHOS, 2000, 53 (01) :1-20
[3]   Long-term treatment in children with hypopituitarism: Pubertal development and final height [J].
Birnbacher, R ;
Riedl, S ;
Frisch, H .
HORMONE RESEARCH, 1998, 49 (02) :80-85
[4]   Adult height in growth hormone (GH)-deficient children treated with biosynthetic GH [J].
Blethen, SL ;
Baptista, J ;
Kuntze, J ;
Foley, T ;
LaFranchi, S ;
Johanson, A .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (02) :418-420
[5]   CATCH-UP GROWTH IN EARLY TREATED PATIENTS WITH GROWTH-HORMONE DEFICIENCY [J].
BOERSMA, B ;
RIKKEN, B ;
WIT, JM ;
JANSEN, M ;
DEMUINCKKEIZERSCHRAMA, SMPF ;
OOSTDIJK, W ;
OTTEN, BJ ;
VULSMA, T .
ARCHIVES OF DISEASE IN CHILDHOOD, 1995, 72 (05) :427-431
[6]   FINAL HEIGHT IN CHILDREN WITH GROWTH-HORMONE DEFICIENCY [J].
BRAMSWIG, J ;
SCHLOSSER, H ;
KIESE, K .
HORMONE RESEARCH, 1995, 43 (04) :126-128
[7]   Insulin-like growth factor binding protein-3 generation as a measure of GH sensitivity [J].
Buckway, CK ;
Selva, KA ;
Pratt, KL ;
Tjoeng, E ;
Guevara-Aguirre, J ;
Rosenfeld, RG .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2002, 87 (10) :4754-4765
[8]   The IGF-I generation test revisited: A marker of GH sensitivity [J].
Buckway, CK ;
Guevara-Aguirre, J ;
Pratt, KL ;
Burren, CP ;
Rosenfeld, RG .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2001, 86 (11) :5176-5183
[9]   Effects of dose and gender on the growth and growth factor response to GH in GH-deficient children: Implications for efficacy and safety [J].
Cohen, P ;
Bright, GM ;
Rogol, AD ;
Kappelgaard, AM ;
Rosenfeld, RG .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2002, 87 (01) :90-98
[10]   Final height in idiopathic growth hormone deficiency: the KIGS experience [J].
Cutfield, W ;
Lindberg, A ;
Wikland, KA ;
Chatelain, P ;
Ranke, MB ;
Wilton, P .
ACTA PAEDIATRICA, 1999, 88 :72-75