Near final and final adult height in egyptian patients with isolated idiopathic growth hormone deficiency treated with recombinant growth hormone

الملخص EN

Background : Despite the availability of growth hormone (GH) therapy that is unlimited by production capacity, many studies show that most patients still fail to reach their genetic target heights.

Objectives : to evaluate the final and near final adult height in Egyptian children with isolated idiopathic growth hormone deficiency and to determine factors affecting adult height.

Subjects and methods : this is a retrospective study including patients diagnosed with isolated idiopathic growth hormone deficiency and on GH therapy who reached their near final or final adult height.

All these data are obtained: onset of the condition, age at diagnosis and start of therapy, duration of delay of therapy, duration of treatment, and full anthropometric data including : target height, estimated mature height, serial height, weight, growth velocity measurements and their SDS, bone age, and stage of puberty at start of therapy and age of spontaneous puberty.

Results : Eighty-seven out of 374 patients with isolated idiopathic growth hormone deficiency reached final and near final adult height.

They are 53 males and 34 females.

The mean near final adult height (NFAH) SDS in boys is -2.34 ± 2.46 and their mean final adult height (FAH) SDS is -2.31 ± 0.34.

While the mean NFAH SDS in girls is – 2.25 ± 1.89 and their FAH SDS is -2.38 ± 1.74.

Their height gain SDS was 1.46 ± 1.1 SDS for males and 1.48 ± 0.62 SDS for females.

The height gain after reaching near final height was 2.2 ± 1.3 cm in males and 1.97 ± 1.1 cm in females.

FAH SDS was positively correlated to basal height SDS (p = 0.0001) and age at onset of puberty (0.02), age at start of therapy (p = 0.02), degree of growth hormone deficiency (p = 0.02), and duration of GH treatment (p = 0.03).

Conclusions : FAH of GH deficient children is below their target height by1.0 ± 0.9 SDS with 88 % within their target range.

Early diagnosis, intensifying therapy before puberty, compliance and continuation of therapy will help to improve their FAH.