Adult Height in Short Children Born SGA Treated with Growth Hormone and Gonadotropin Releasing Hormone Analog: Results of a Randomized, Dose-Response GH Trial

Lem, Annemieke J.; Kaay, Daniëlle C M van der; Ridder, Maria A. J. de; Waarde, Willie M. Bakker-van; Hulst, Flip J. P. C. M. van der; Mulder, Jaap C.; Noordam, C.; Odink, Roel J.; Oostdijk, Wilma; Schroor, Eelco J.; Sulkers, Esther; Westerlaken, Ciska; Hokken-Koelega, Anita

doi:10.1210/jc.2012-1987

Cited by 73 publications

(46 citation statements)

References 84 publications

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“…In contrast, Hokken-Koelega and colleagues [58] have shown that treatment with a higher dose of GH (2 mg/m 2 /day) during puberty resulted in a significantly better adult height than low-dose (1 mg/m 2 /day) GH treatment. Although GnRH analog treatment might reduce growth velocity, evidence suggests that combined GH and GnRH analog treatment may improve adult height in SGA children who are short at the start of puberty (<140 cm) and have a poor adult height expectation.…”

Section: Growth Hormone Treatment and Pubertal Developmentmentioning

confidence: 97%

“…Although GnRH analog treatment might reduce growth velocity, evidence suggests that combined GH and GnRH analog treatment may improve adult height in SGA children who are short at the start of puberty (<140 cm) and have a poor adult height expectation. These children might also need a higher GH dose [58]. …”

Section: Growth Hormone Treatment and Pubertal Developmentmentioning

confidence: 99%

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Puberty in Children Born Small for Gestational Age

Verkauskienė

Petraitienė²,

Wikland³

2013

Horm Res Paediatr

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Small for gestational age (SGA) children are more prone to have precocious pubarche and exaggerated precocious adrenarche, an earlier onset of pubertal development and menarche, and faster progression of puberty than children born of appropriate for gestational age (AGA) size. The majority of studies investigating the onset of puberty in children born SGA and AGA established that, although puberty begins at an appropriate time (based on chronological age and actual height) in SGA children, onset is earlier relative to AGA children. Evaluating pubertal growth in SGA children, a more modest bone age delay from chronological age at the onset of puberty and more rapid bone maturation during puberty compared to AGA children were reported. Peak height velocity in adolescence is reached at an earlier pubertal stage and lasts for a shorter period in children born SGA than in those born AGA. These differences lead to an earlier fusion of the growth plates and a shorter adult height. The pathophysiological mechanism underlying the unique pubertal growth pattern of children born SGA remains unclear. However, it seems that this is not only related to birth weight, gestational age, adiposity or obesity, but that there may also be an influence of rapid weight gain in early childhood on pubertal onset: excess weight gain in childhood may be related to central adiposity, decreased insulin sensitivity, and increased IGF-I levels and might thus predispose to precocious pubarche.

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Section: Growth Hormone Treatment and Pubertal Developmentmentioning

confidence: 97%

Section: Growth Hormone Treatment and Pubertal Developmentmentioning

confidence: 99%

Puberty in Children Born Small for Gestational Age

Verkauskienė

Petraitienė²,

Wikland³

2013

Horm Res Paediatr

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“…However, in 17 patients with SRS in this study, puberty was postponed for 2 years with gonadotropin-releasing hormone analogue (GnRHa) due to a low predicted adult height. The effect of GnRHa on final height has been analysed in a cohort of patients with SGA, including patients with SRS 120,121 . This analysis suggested that the combination of GnRHa, started at the initiation of puberty and continued for at least 2 years, along with GH treatment, improves adult height in patients born SGA with a poor adult height prognosis.…”

Section: Bone Age Advancement and Pubertymentioning

confidence: 99%

Diagnosis and management of Silver–Russell syndrome: first international consensus statement

et al. 2016

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“…Since treatment around the onset of puberty has been shown to produce limited effects52), Lem et al57) studied the effect of GH and gonadotropin releasing hormone analogue in a randomized trial. They concluded that when SGA children are short at the start of puberty, they could benefit from combined GH/GnRH treatment.…”

Section: Small For Gestational Agementioning

confidence: 99%

Growth hormone treatment in non-growth hormone-deficient children

Loche

Carta

Ibba

et al. 2014

Ann Pediatr Endocrinol Metab

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Until 1985 growth hormone (GH) was obtained from pituitary extracts, and was available in limited amounts only to treat severe growth hormone deficiency (GHD). With the availability of unlimited quantities of GH obtained from recombinant DNA technology, researchers started to explore new modalities to treat GHD children, as well as to treat a number of other non-GHD conditions. Although with some differences between different countries, GH treatment is indicated in children with Turner syndrome, chronic renal insufficiency, Prader-Willi syndrome, deletions/mutations of the SHOX gene, as well as in short children born small for gestational age and with idiopathic short stature. Available data from controlled trials indicate that GH treatment increases adult height in patients with Turner syndrome, in patients with chronic renal insufficiency, and in short children born small for gestational age. Patients with SHOX deficiency seem to respond to treatment similarly to Turner syndrome. GH treatment in children with idiopathic short stature produces a modest mean increase in adult height but the response in the individual patient is unpredictable. Uncontrolled studies indicate that GH treatment may be beneficial also in children with Noonan syndrome. In patients with Prader-Willi syndrome GH treatment normalizes growth and improves body composition and cognitive function. In any indication the response to GH seems correlated to the dose and the duration of treatment. GH treatment is generally safe with no major adverse effects being recorded in any condition.

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Adult Height in Short Children Born SGA Treated with Growth Hormone and Gonadotropin Releasing Hormone Analog: Results of a Randomized, Dose-Response GH Trial

Abstract: When started in adolescence, GH treatment significantly improves AH in short SGA children, particularly with GH 2 mg/m(2) · d during puberty. When SGA children are short at the start of puberty, they can benefit from combined GH/GnRHa treatment.

Cited by 73 publications

References 84 publications

Puberty in Children Born Small for Gestational Age

Puberty in Children Born Small for Gestational Age

Diagnosis and management of Silver–Russell syndrome: first international consensus statement

Growth hormone treatment in non-growth hormone-deficient children

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