Is a Two-Year Growth Response to Growth Hormone Treatment a Better Predictor of Poor Adult Height Outcome Than a First-Year Growth Response in Prepubertal Children With Growth Hormone Deficiency?

S. Straetemans*, R. Rooman, J. De Schepper, BESPEED

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

ObjectiveThe first year response to growth hormone (GH) treatment is related to the total height gain in GH treated children, but an individual poor first year response is a weak predictor of a poor total GH effect in GH deficient (GHD) children. We investigated whether an underwhelming growth response after 2 years might be a better predictor of poor adult height (AH) outcome after GH treatment in GHD children.Design and methodsHeight data of GHD children treated with GH for at least 4 consecutive years of which at least two prepubertal and who attained (near) (n)AH were retrieved from the Belgian Register for GH treated children (n = 110, 63% boys). In ROC analyses, the change in height (Delta Ht) SDS after the first and second GH treatment years were tested as predictors of poor AH outcome defined as: (1) nAH SDS <-2.0, or (2) nAH SDS minus mid-parental height SDS <-1.3, or (3) total Delta Ht SDS ResultsEleven percent of the cohort had a total Delta Ht SDS 70%. First-year Delta Ht SDS <0.41 correctly identified 42% of the patients with poor AH outcome at a 95% specificity level, resulting in respectively 5/12 (4.6%) correctly identified poor final responders and 5/98 (4.5%) misclassified good final responders (ratio 1.0). Delta Ht SDS after 2 prepubertal years had a cut-off level of 0.65 and a sensitivity of 50% at a 95% specificity level, resulting in respectively 6/12 (5.5%) correctly identified poor final responders and 5/98 (4.5%) misclassified good final responders (ratio 1.2).ConclusionIn GHD children the growth response after 2 prepubertal years of GH treatment did not meaningfully improve the prediction of poor AH outcome after GH treatment compared to first-year growth response parameters. Therefore, the decision to re-evaluate the diagnosis or adapt the GH dose in case of poor response after 1 year should not be postponed for another year.
Original languageEnglish
Article number678094
Number of pages9
JournalFrontiers in Endocrinology
Volume12
DOIs
Publication statusPublished - 1 Jun 2021

Keywords

  • growth hormone treatment
  • growth hormone deficiency
  • children
  • growth response
  • poor adult height outcome
  • GESTATIONAL-AGE
  • GH TREATMENT
  • 1ST YEAR
  • MANAGEMENT
  • DIAGNOSIS
  • THERAPY
  • BIRTH

Fingerprint

Dive into the research topics of 'Is a Two-Year Growth Response to Growth Hormone Treatment a Better Predictor of Poor Adult Height Outcome Than a First-Year Growth Response in Prepubertal Children With Growth Hormone Deficiency?'. Together they form a unique fingerprint.

Cite this