The aim of this study was to test the effect of growth hormone (GH) therapy on final height in peripubertal boys with idiopathic short stature in whom a subnormal integrated concentration of GH ( < 3.2 µg/l) was found. Twenty-eight peripubertal children were studied. Height was below 2 SD for age, growth velocity was < 4.5 cm/year, bone age was more than 2 SD below mean for age and GH response to provocative tests was more than 10 µg/l. Eleven subjects (group B) were treated with recombinant GH 0.75 unit/kg/week, divided into 3 weekly doses for 2 years, and then the same weekly dose divided into daily injections was administered until final height was attained. Seventeen untreated children (group A) who were followed until cessation of growth served as controls. The GH-treated patients reached their target heights (-2.1 ± 0.5, mean ± SD in SDS) and predicted heights (-1.8 + 0.8) determined by the Bayley and Pinneau method, while the final heights of the untreated patients were significantly lower than their target heights and their predicted final heights (-2.7 ± 0.7, -1.8 ± 1.0 and -2.7 ± 0.7, respectively). The main effect of GH was observed during the 1 st year of treatment when height velocity was significantly higher in the GH-treated group than in the untreated one (9.3 ± 2.1 vs. 5.3 ± 1.1 respectively, p < 0.001). The high cost of the treatment in this specific age group should be weighed against the results.

Objective: Characterization of pubertal progression is required to prevent unnecessary intervention in unsustained or slowly progressive (SP) precocious puberty (PP), while delivering hormonal suppression in rapidly progressive (RP) PP. We aimed to assess the diagnostic value of first-voided urinary LH (ULH) compared with GNRH-stimulated gonadotropins in differentiating these forms of PP. Methods: A total of 62 girls with PP underwent both GNRH stimulation and ULH assay. Fifteen girls with peak LH R10 IU/l started treatment immediately, whereas the other 47 girls were evaluated after 6 months for pubertal advancement, height acceleration, and bone-age maturation. Based on these criteria, the participants were assigned to five subgroups: pubertal regression, no progression or progression by one, two or three criteria. The first three subgroups were defined as SP-PP (nZ29), while the other two subgroups were defined as RP-PP (nZ18). An additional 23 prepubertal girls were evaluated for ULH. Results: ULH but not serum gonadotropins could distinguish girls with two and three criteria from less progressive subgroups. By comparison with SP-PP (i.e. regression group and groups 0 and 1), those with RP-PP (group 2C3) had lower peak FSH (9.28G2.51 vs 12.57G4.30; PZ0.007) and higher peak LH:FSH ratio (0.42G0.30 vs 0.22G0.12; PZ0.022) and ULH (1.63G0.65 vs 1.05G0.26 IU/l; P!0.001). Based on receiver operating characteristics analysis, a ULH cutoff of 1.16 IU/l had a better sensitivity (83%) and positive and negative predictive values (65 and 88% respectively) than the other two parameters, with a specificity of 72%. Conclusions: ULH assay is a noninvasive, reliable method that can assist in the distinction between SP-and RP-PP.

Suppressed basal and post-GnRHa LH levels indicate adequate suppression of puberty. Clinical breakthroughs during treatment are transient and resolved spontaneously.

Males with recent-onset diabetes of Yemenite origin have a significant reduction of β-cell function and reduced ability to compensate for insulin resistance compared with diabetic males of non-Yemenite origin. Both males and females of Yemenite origin have a significantly higher maternal inheritance of diabetes. These data suggest different underlying mechanisms leading to early loss of β-cell in diabetic males of Yemenite origin.