The efficacy of grwoth hormone in different types of growth failure

Lenko, Hanna Liisa; Leisti, Seppo; Perheentupa, Jaakko

doi:10.1007/bf00441210

Cited by 69 publications

(28 citation statements)

References 45 publications

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“…We found no relationship between these two parameters in the permanent group, but the number of weekly injections, which varied from 3 to 7, may have interfered with the result on the growth. The published data on the relationship between the post stimulation GH peak at diagnosis of GH deficiency and the growth response to hGH are also conflicting [16][17][18]. The growth rate before therapy and the chronological age at the start of therapy do not seem to influence the growth response.…”

Section: Discussionmentioning

confidence: 99%

Growth Response to Growth Hormone during the First Year as a Diagnosis Criterion of Growth Hormone Deficiency

Zantleifer

Awadalla²,

Brauner³

1993

Horm Res

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Idiopathic growth hormone (GH) deficiency is a clinically and biologically heterogeneous condition. This study evaluates the capacity of the initial growth response to hGH therapy to distinguish certain from transient GH deficiency. Twenty-five patients having a GH peak < 10 μg/l after 2 pharmacological stimulation tests were classified according to the accuracy of the diagnosis of GH deficiency. Group 1 (n = 17) had certain GH deficiency because of pituitary stalk interruption syndrome and/or familial form. Group 2 (n = 8) had a transient GH deficiency. The mean increase in height standard deviation (SD) was 1.3 ± 0.1 (mean ± SE) and 0.5 ± 0.1 during the first and second years in group 1 and 0.4 ± 0.1 (p < 0.0005, compared to group 1) and 0.1 ± 0.2 (p < 0.025 compared to group 1) during the first and second years in group 2. During the first year of therapy, the increase in height was > 1 SD in 14 patients of group 1 and in 1 patient of group 2. In group 1, this increase was positively correlated with an increase in body mass index (r = 0.80, p < 0.01) during the first year and with target height (r = 0.60, p < 0.02) during the second year. Growth rate (SD for age) during the first year in this group was negatively correlated with the height prior to therapy (r = -0.72, p < 0.005). In group 2, the increase in height was positively correlated with the growth rate before therapy (r = 0.74, p < 0.05) during the first year and with the hGH dose (r = 0.90, p < 0.025) during the second year. We conclude that the growth response during the first year of hGH therapy, interpreted according to the height before therapy, is a good criterion of GH deficiency and that the change in weight influences the growth response in certain GH deficiency. The group of transient GH deficiency emphasizes the need to perform additional evaluations of GH secretion in children having GH deficiency without anatomical lesion and increase in height lower than 1 SD during the first year of hGH therapy.

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Section: Discussionmentioning

confidence: 99%

Growth Response to Growth Hormone during the First Year as a Diagnosis Criterion of Growth Hormone Deficiency

Zantleifer

Awadalla²,

Brauner³

1993

Horm Res

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“…A spectrum of GH deficiency from complete absence to borderline GH production is recognised. Within this population, patients with isolated GH deficiency function better than those with multiple pituitary hormone deficiencies [8]. The failure of GH-deficient children to achieve a normal pubertal growth spurt results in an even greater final height deficit compared to their peers [9].…”

Section: Introductionmentioning

confidence: 99%

An Analysis of the Clinical and Cost Effectiveness of Growth Hormone Replacement Therapy before and during Puberty: Should We Increase the Dose?

Howard

Butler

2013

Horm Res Paediatr

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Aim: To investigate the influence of growth hormone (GH) on linear growth before and during puberty in children with GH deficiency. Methods: We analysed the relationship between pubertal growth and GH dose in a large dataset of children (n = 236) with GH deficiency using multiple linear regression and multilevel modelling with repeated measures analysis. Additionally, we examined the cost benefit of increasing doses of GH during puberty. Results: Multilevel modelling revealed a highly significant role for GH dose in the pre-pubertal period (p < 0.001), but a non-significant effect on height gain after pubertal onset (p = 0.32). Important predictors of height gain after puberty onset included gender, age at puberty and number of injections of GH/week. Cost analysis showed that in an average child use of high dose GH, at an extra EUR 5,925 (GBP 4,753/USD 7,538)/year, would produce a height gain of 0.80 cm/year (above baseline growth) pre-pubertally, compared to only 0.20 cm/year post-puberty onset. Conclusions: The influence of GH dose on height gain after puberty onset is at best a modest one. Cost analysis shows use of high doses of GH post-puberty onset has significant cost implications without providing a worthwhile gain in adult height for children with GH deficiency.

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“…When this study was planned in 1988, we were aware of the abnormalities recorded in the spontaneous growth hormone (GH) secretion of girls with Turner syndrome [1] and the 2-year results of a large multicentre study of human GH therapy in Turner syndrome in the USA sug gesting that GH increases the height velocity of these girls and might also increase their final height [2], Our own earlier experience of GH therapy in T urner syndrome was less positive [3], Although the patients initially had a clear growth spurt, after the second year of GH treatment, it waned, and their final height remained modest. The aim of this national multicentre study was firstly to evaluate whether the height velocity of girls with Turner syndrome increases with the GH regimen conventionally used for treatment of GH deficiency (GHD) to such an extent that the diagnosis of GH neurosecretory dysfunction may be made, and secondly, to determine whether this therapy affects adult height prognosis and, eventually, the final height attained.…”

Section: Introductionmentioning

confidence: 99%

Effect of Conventional Dose Growth Hormone Therapy for Two Years on Height Velocity and Height Prognosis in Girls with Turner Syndrome

Lenko

Hakulinen²,

Käär³

et al. 1993

Horm Res

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The aims of this national multicentre study in Finland were to evaluate whether the height velocity of patients with Turner syndrome would increase with the conventional human growth hormone (GH) therapy regimen normally given to GH-deficient children and whether girls with Turner syndrome actually show GH neurosecretory dysfunction. Finally, the study should show whether GH therapy improves height prognosis and, eventually, final height. Twenty-five girls with Turner syndrome, aged 7.5-14.4 years, entered the study. Their ability to secrete GH was determined and, surprisingly, several would have been classified as having GH deficiency. All girls received GH, 0.1 IU/kg/day (maximum dose 4 IU/day) s.c, and once over 12.5 years old, they also received oestradiol valerate and fluoxymesterone. They showed a convincing increase in height velocity, and rapid growth continued during the second year of therapy. The effect of GH therapy on final height is still unknown. The therapy was remarkably free of side-effects.

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The efficacy of grwoth hormone in different types of growth failure

Cited by 69 publications

References 45 publications

Growth Response to Growth Hormone during the First Year as a Diagnosis Criterion of Growth Hormone Deficiency

Growth Response to Growth Hormone during the First Year as a Diagnosis Criterion of Growth Hormone Deficiency

An Analysis of the Clinical and Cost Effectiveness of Growth Hormone Replacement Therapy before and during Puberty: Should We Increase the Dose?

Effect of Conventional Dose Growth Hormone Therapy for Two Years on Height Velocity and Height Prognosis in Girls with Turner Syndrome

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