Growth hormone treatment of short children born small for gestational age: metanalysis of four independent, randomized, controlled, multicentre studies

Zegher, Francis de; Albertsson‐Wikland, Kerstin; Wilton, Patrick; Chatelain, Pierre; Jonsson, Björn; Löfström, Annika; Butenandt, O; Chaussain, J L

doi:10.1111/j.1651-2227.1996.tb14289.x

Cited by 61 publications

(64 citation statements)

References 19 publications

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“…Moreover, we found that age at start and the duration of GH treatment were the strongest variables correlating with height gain. These results agree also with the study of Sas et al (13), as well as the results from meta-analysis of four European trials (15), although neither is yet to adult height.…”

Section: Final Height In Short Sga On Ghsupporting

confidence: 82%

“…Most studies report correlations with age at start of GH treatment (13,16,30), one with height SDS at start (30) and others with the prepubertal GH dose (13,15,16,30). We observed no correlation between response to GH and pretreatment height velocity.…”

Section: Final Height In Short Sga On Ghcontrasting

confidence: 45%

“…Boguszewski et al (11,12) reported that short children born SGA have both lower mean GH secretion rates and lower serum IGF-I (IGF-I) values than children born AGA. In children born SGA, there is a correlation between the GH dose and the growth response, mainly during prepubertal years (13)(14)(15)(16). The majority of short children born SGA show improvement in growth rate during GH treatment, particularly if treatment is begun early (14,16).…”

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confidence: 99%

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Final Height in Short Children Born Small for Gestational Age Treated with Growth Hormone

2005

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The aim of this observational study was to assess the longterm growth responses to GH treatment of children born small for gestational age (SGA). GH treatment was begun before puberty and continued to final height (FH). Seventy-seven short (height SD score below Ϫ2) prepubertal children born SGA (below Ϫ2 SD for birth weight and/or birth length), with a broad range of GH secretory capacity, were treated with GH in a daily dose of 33 g/kg (0.1 U/kg), beginning before the onset of puberty. We observed a difference between adult and pretreatment projected height of 1.3 SD (9 cm) for the entire group. Among the children treated for Ͼ2 y before puberty, this mean gain (i.e. difference) in final height was 1.7 SD, whereas the mean gain was 0.9 SD among those in whom treatment was begun Ͻ2 y before puberty. Better catch-up growth was observed in the younger (r ϭ Ϫ0.56, p Ͻ 0.0001), shorter (r ϭ Ϫ0.49, p Ͻ 0.0001), and lighter (r ϭ Ϫ0.46, p Ͻ 0.0001) subjects. We conclude that GH treatment improves the final height of short children born SGA. The height gain attained before the onset of puberty is maintained to final height. The younger, shorter, and lighter the child at the start of GH treatment, the better the response. Moreover, most of these SGA individuals treated with GH reach their target height. There is a 5-to 7-fold higher risk of short stature among adults who were born SGA, compared with those born AGA (1,2). Children born SGA comprise one-third of children who are short during childhood (1). As short stature is present in 10 -15% of children born SGA (1-3), efforts have been made to understand the etiology of their growth restriction and to increase their FH.Birth length has been shown in population-based studies to be the single most important predictor of adult height (1,2). Short children born SGA keep their prepubertal height SDS to FH, whereas short children born AGA gain further 0.6 -0.7 SDS in height during puberty (4). French data show that adult men who were born SGA are, on average 7.5 cm, and women are 9.6 cm below their mid-parent target height (5). This is at the lower end of the range compared with other studies (1,6,7), which find a growth deficit of 0.7-0.9 SDS below the MPH.Either low GH secretion or reduced sensitivity to GH may account for some of the growth retardation of children born SGA (8 -10). Boguszewski et al. (11,12) reported that short children born SGA have both lower mean GH secretion rates and lower serum IGF-I (IGF-I) values than children born AGA. In children born SGA, there is a correlation between the GH dose and the growth response, mainly during prepubertal years (13-16). The majority of short children born SGA show improvement in growth rate during GH treatment, particularly if treatment is begun early (14,16). With the exception of one large study (17), however, no information is available on the FH achieved by short children born SGA and treated with GH from a young age to FH. We report here the observational data on the effect of GH therapy on final height of childr...

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Section: Final Height In Short Sga On Ghsupporting

confidence: 82%

Section: Final Height In Short Sga On Ghcontrasting

confidence: 45%

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confidence: 99%

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Final Height in Short Children Born Small for Gestational Age Treated with Growth Hormone

2005

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“…Although highdose GH treatment may have induced some degree of insulin resistance, no significant alterations in fasting blood glucose or hemoglobin A1c were identified after 2 years (11).…”

Section: Study Design Materials and Methodsmentioning

confidence: 99%

“…We summarize recent growth data from four independent, randomized, controlled, multicenter studies exploring the effects of three doses of daily GH administration over two years in short children born small for gestational age (11).…”

Section: Introductionmentioning

confidence: 99%

Growth Hormone Treatment of Short Children Born Small for Gestational Age

Zegher

1997

Clin Pediatr Endocrinol

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The Growth Hormone Secretory Pattern and Statural Growth

Robinson¹,

Hindmarsh

1999

Comprehensive Physiology

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The sections in this article are: How is the Growth Hormone Secretory Pattern Analyzed? General Considerations in Pulse Analysis of Growth Hormone Secretion Construction of Data Arrays or Hormone Profiles Sampling Interval and Aliasing Duration of Sampling Discrete or Integrated Samples Assays and Noise Basic Evaluation Stationarization Analysis of Profiles Time Series Analysis Deconvolution Analysis Baseline Occupancy Chaos Neural Networks Characterization of Growth Hormone Secretory Patterns Ontogeny of Episodic Growth Hormone Secretion Growth Hormone Secretory Patterns in the Prepubertal Period Puberty and Effects of Gonadal Steroids on the Growth Hormone Secretory Pattern Growth Hormone Secretory Patterns in Adulthood Other Endocrine Inputs Affecting Growth Hormone Secretory Patterns Extrinsic Factors Affecting Growth Hormone Pulsatility How Does the Growth Hormone Secretory Pattern Reflect the Episodic Nature of Hypothalamic Control Mechanisms? Growth Hormone–Releasing Hormone and Somatostatin Interactions Generate Growth Hormone Pulsatility Other Growth Hormone Secretogogues Growth Hormone Feedback Effects on Endogenous Growth Hormone Pulsatility How is The Growth Hormone Secretory Signal Modified in its Passage from the Pituitary to the Peripheral Target Tissues? How Are Growth Hormone Patterns Modified by Interactions with Growth Hormone Binding Proteins? How are the Temporal Elements of the Growth Hormone Signal Detected and Interpreted by the Target Tissues? Pattern‐Dependent Growth Hormone Responses Growth Hormone Patterns and Insulin‐Like Growth Factor I Generation What is the Significance of the Growth Hormone Secretory Pattern for Statural Growth? Animal Studies Human Studies Indirect Manipulation of Growth Hormone Secretory Pattern Summary

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Growth hormone treatment of short children born small for gestational age: metanalysis of four independent, randomized, controlled, multicentre studies

Cited by 61 publications

References 19 publications

Final Height in Short Children Born Small for Gestational Age Treated with Growth Hormone

Final Height in Short Children Born Small for Gestational Age Treated with Growth Hormone

Growth Hormone Treatment of Short Children Born Small for Gestational Age

The Growth Hormone Secretory Pattern and Statural Growth

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