Evaluation of Growth Hormone Results in Different Diagnosis and Trend Over 10 Year of Follow-up: A Single Center Experience

Abstract

Objective: The aim was to evaluate the results of diagnosis, follow-up and treatment of the patients who recieved growth hormone (GH) treatment for the last 10 years and to determine the differences in the process and results over the years. Methods: Anthropometric, clinical, laboratory data, treatment adherence and side effects were evaluated retrospectively in 767 patients who recieved GH treatment between 2009-2018. Patients were grouped as isolated GH deficiency (IGHD), multiple pituitary hormone deficiency (MPHD), small for gestational age (SGA), and Turner syndrome (TS) depending on diagnosis. Results: GH treatment was started in 689 cases (89.8%) with IGHD, 24 (3.1%) with MPHD, 26 (3.4%) with SGA and 28 (3.7%) with TS. Median age of GH treatment onset was the earliest in SGA (8.4 years) and the latest in the IGHD group (12.0 years). At the time of treatment cessation, height standard deviation score (SDS) in IGHD and MPHD was significantly higher than treatment initiation time, whereas there was no significant difference in TS and SGA. One hundred eighty-nine cases reached the final height. Final heights for girls/boys were: IGHD 154/164.9 cm; MPHD 156.2/163.5 cm; TS 146.7 cm; and SGA 145.7/-cm, respectively. Target height SDS-final height SDS median values were IGHD: 0.1, MPHD: 0.6, SGA: 0.5, TS: 2.4 respectively. The patients’ treatment compliance was high (92%) and the incidence of side effects was low (2.7%). Conclusion: In our cohort, GH treatment start age was late and no difference in this was observed in the last 10 years. The improvement in the height SDS was most marked in the IGHD and MPHD groups, the least in the TS and SGA groups.

Long-term follow-up data of patients with Multiple Pituitary Hormone Deficiency

“…En nuestro estudio, los valores medios de SDS de la estatura de los casos al momento de la presentación fueron superiores a los de estudios de la literatura que evalúan el crecimiento y desarrollo en casos con DCHH 13,20,21 . Esto se atribuyó a la menor edad al momento del diagnóstico de nuestros casos.…”

“…Estudios han reportado que los niños con deficiencia severa de HC presentan un mayor riesgo de desarrollar DCHH, independientemente de la etiología subyacente 15 . En un estudio previo realizado en nuestra clínica, se observó que las respuestas máximas de HC obtenidas en las pruebas de estimulación eran menores en los casos con DCHH que en aquellos con DAHC, y la SDS de IGF-1 estaba por debajo de -2 SDS en el 80% del grupo con DCHH y en el 43% del grupo con DAHC 21 . En nuestro estudio, la deficiencia com-…”