Magnetic resonance imaging of knees: a novel approach to predict recombinant human growth hormone therapy response in short-stature children in late puberty

Abstract

Background There is no appropriate tool to predict recombinant human growth hormone (rhGH) response before therapy initiation in short-stature children in late puberty. The current study aimed to explore the associations between magnetic resonance imaging (MRI) stages of the knee growth plates and rhGH response in short-stature children in late puberty. Methods In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later. Results Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV1-3 mon from 9.38 to 6.08 to 4.56 cm/year, GV4-6 mon from 6.75 to 4.92 to 3.25 cm/year, and height gain from 4.03 to 2.75 to 1.95 cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01). Conclusion The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty. Graphical abstract

Genotype and phenotype in patients with ACAN gene variants: Three cases and literature review

“…Most children are diagnosed with idiopathic short stature (ISS) for unknown reasons. The normal growth of children is regulated by many systems, including multiple hormones (growth hormone, thyroid hormone, and sex hormones), paracrine factors, extracellular matrix molecules, and intracellular proteins that regulate the activity of growth plate chondrocytes (Bai et al., 2023; Baron et al., 2015). Short stature can potentially be caused by variants in any of the genes that directly or indirectly affect growth plate chondrocytes and the process of growth plate chondrogenesis (Baron et al., 2015).…”