Comparison between the growth response to growth hormone (GH) therapy in children with partial GH insensitivity or mild GH deficiency

Abstract

Objectives: GH therapy is still controversial, except in severe GH deficiency (SGHD). The objective of this study was to compare the response to growth hormone (GH) therapy in children with partial GH insensitivity (PGHIS) and mild GH deficiency (MGHD) with those with SGHD.Subjects and methods: Fifteen PGHIS, 11 MGHD, and 19 SGHD subjects, followed up for more than one year in the Brazilian public care service, were evaluated regarding anthropometric and laboratory data at the beginning of treatment, after one year (1 st year) on treatment, and at the last assessment (up to ten years in SGHD, up to four years in MGHD, and up to eight years in PGHIS).Results: Initial height standard deviation score (SDS) in SGHD was lower than in MGHD and PGHIS. Although the increase in 1 st year height SDS in comparison to initial height SDS was not different among the groups, height-SDS after the first year of treatment remained lower in SGHD than in MGHD. There was no difference in height-SDS at the last assessment of the children among the three groups. GH therapy, in the entire period of observation, caused a trend towards lower increase in height SDS in PGHIS than SGHD but similar increases were observed in MGHD and SGHD.Conclusion: GH therapy increases height in PGHIS and produces similar height effects in MGHD and SGHD.

Response to growth hormone according to provocation test results in idiopathic short stature and idiopathic growth hormone deficiency

“…Some have reported that the partial GHD group showed a lower growth response than the complete GHD group [ 18 , 21 ]. In contrast, Cardoso et al [ 22 ] found no difference in growth response after 1 year of GH treatment between the complete and partial GHD groups.…”

An Update on Subclinical Hypopituitarism

“…Height-SDS after the first year of treatment was higher in children with mild deficiency compared with those with severe deficiency, but no difference was found at the last assessment. Differences in GH doses were not observed [44].…”

Significance of Direct Confirmation of Growth Hormone Insensitivity for the Diagnosis of Primary IGF-I Deficiency

“…[18], who have proposed starting from rIGF-I replacement only in patients unresponsive to rhGH due to known hormone signaling defects, while in unexplained cases of IGFD, a trial of rhGH therapy has been suggested. An important argument against starting treatment in children with unknown molecular cause of IGFD from rIGF-I is the observation that patients with so-called partial GHI may benefit during rhGH therapy similarly to those with mild GHD [41].…”