Effect of growth hormone on short normal children.

Abstract

The growth of 26 short normal prepubertal children (mean age 8-4, height velocity standard deviation score for chronological age between +0-4 and -0-8) was studied for two years. Sixteen children were treated with somatrem (methionyl growth hormone) during the second year, and the remaining 10 children served as controls. During one year of treatment the height velocity standard deviation score for chronological age increased from the pretreatment mean of -044 (SD 0.33) to +2*20 (1.03). These values represented a change in height velocity from a pretreatment mean of 5-3 cm/year (range 4.6-6.9) to 7-4 cm/year (range 5-7-9-9). In the control group the height velocity standard deviation score was unchanged. Bone age advanced by 0-75 (0-33) years in the treated group compared with 0-70 (0.18) years in the control group. There was a significant increase in the height standard deviation score for bone age (0-63 (0.55)) in the treated group.Multiple regression analysis of predictive factors contributing to the change in height velocity standard deviation score over the first year of treatment showed that the dose of growth hormone and pretreatment height velocity standard deviation score were important, together yielding a regression correlation coefficient of 0-80. The only metabolic side effect of treatment was an increase in fasting insulin concentration, which may be an important mediator of the anabolic effects of growth hormone. Treatment had no effect on thyroid function, blood pressure, or glucose tolerance. At the end of the treatment year seven of the 16 treated children had developed antibodies to growth hormone, but they were present in low titre with low binding capacity and in no child was growth attenuated.Biosynthetic growth hormone improved the height velocity of children growing along or parallel to the third height centile, but the effects on height prognosis need to be assessed over a longer period. IntroductionWe have recently shown an asymptomatic relation between the height velocity of short prepubertal children and the amount of growth hormone secreted over 24 hours.' The implication of this relation was, firstly, that children growing poorly and secreting little growth hormone would respond best to growth hormone treatment, a hypothesis well tested and proved by experience with human growth hormone treatment2 3; and, secondly, short children growing with a normal growth velocity would also respond, albeit to a lesser extent.The second hypothesis has not been tested to any extent owing to limited supplies of human growth hormone. Several groups have reported a beneficial effect of exogenous growth hormone in short "normal" children, but the definition of normality was based predominantly on the biochemical response to pharmacological testing with little account taken of the children's growth rate.49 If children are not to gain or lose height compared with their peers then they must grow with a 50th centile height velocity.'0 In practice, as children growing along or parallel to the third...

Long‐term results of growth hormone therapy in children with short stature, subnormal growth rate and normal growth hormone response to secretagogues

“…Theoretically, such children would increase their growth rate on a regular substitution dosage of GH, while children with an adequate GH secretion and a relative GH insensitivity would need a higher dosage to grow faster. This hypothesis is supported by the observation that G H treatment in various dosages leads to a significant acceleration of the average height velocity during the first years of treatment, though with a considerable inter-individual variation (Hopwood et al, 1993;Hindmarsh & Brook, 1987;Moore et ai., 1992).…”

“…The present study, as well as previous papers (Hopwood er al., 1993;Hindmarsh &Brook, 1987;Mooreet al, 1992;Wit et al, 1989a,b;, demonstrates that GH therapy in a daily dose of 1-2 times the substitution dose leads to increased growth velocity over several years in children with ISS, resulting in a HSDS increment of 1.5, provided that the dosage is adapted to the individual sensitivity. The average response, however, was less than the response of children with 'classic' isolated GHD to a substitution dosage (approximately 2 SD over 4 years) and the mean height remained below the 3rd percentile.…”

Computational stabilization of human growth hormone

“…It plays an important role in somatic growth through its effects on the metabolism of proteins, carbohydrates, and lipids. hGH is currently used for the treatment of pediatric hypopituitary dwarfism and in children suffering from low levels of hGH (Hindmarsh and Brook 1987). It is believed that hGH functions by direct action on bone and soft tissue to cause uniform growth and by indirect stimulation of insulin-like growth factor-1 (Pearlman and Bewley 1993).…”

The effects of growth hormone treatment on lipid parameters

“…It is thought that the opposite effects of GH and IGF-1 on lipid metabolism balance each other. It was shown that GH positively affected 10 annual height increase in short stature normal children but did not change lipid metabolism [12][13][14]. There are some researches indicating the relationship between android type lipid distribution and hypertension, diabetes mellitus, stroke and myocardial infarction.…”