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Growth hormone dose-dependent pubertal growth: a randomized trial in short children with low growth hormone secretion
Goteborg Pediat Growth Res Ctr, Dept Pediat, Inst Clin Sci, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
Dept Clin Sci, Pediat Unit, Umeå Univ, Umeå, Sweden.
Dept Clin Sci, Pediat Unit, Umeå Univ, Umeå, Sweden.
Dept Pediat, Halmstad Cty Hosp, Halmstad, Sweden.
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2014 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 82, no 3, p. 158-170Article in journal (Refereed) Published
Abstract [en]

Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency.

Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height.

Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS.

Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.

Place, publisher, year, edition, pages
2014. Vol. 82, no 3, p. 158-170
Keywords [en]
Gain in height, Prepubertal growth, Growth hormone frequency, Delayed infancy-childhood transition, Puberty
National Category
Endocrinology and Diabetes Pediatrics
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-40185DOI: 10.1159/000363106ISI: 000345448500003PubMedID: 25170833Scopus ID: 2-s2.0-84906588161OAI: oai:DiVA.org:oru-40185DiVA, id: diva2:776436
Note

Funding Agencies:

Swedish Foundation for Pediatric GH Research

Foundation Vaxthuset for Children

University Hospital Government Grants (ALF) in Gothenburg and in Umå

Kabi/Pharmacia

Available from: 2015-01-07 Created: 2015-01-07 Last updated: 2018-06-14Bibliographically approved

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Åman, Jan

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