ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P584

Growth hormone deficient children born small-for-gestational-age need higher than replacement dose of hGH for successful treatment

Ferenc Péter1, Andrea Luczay2, Eniko Sólyom3, Balázs Gellén4, Tamás Niederland5, Eniko Felszeghy6, László Ságodi3, János Sólyom2 & Ágota Muzsnai1

1Buda Children’s Hospital, Budapest, Hungary; 2Semmelweis University, 2nd Pediat Department, Budapest, Hungary; 3Child-health Centre, Miskolc, Hungary; 4Szentgyörgyi University, Pediat Department, Szeged, Hungary; 5Petz Aladár Hospital, Pediat Department, Gyor, Hungary; 6University Pediat Department, Debrecen, Hungary.

Growth hormone deficient (GHD) children born small-for-gestational-age (SGA) receive the same hGH dose as the children born with appropriate weight/length for gestational age (AGA). There are very few data on their lower growth response to the usual GH replacement dose. The aim of this multi-centre retrospective study is to analyse the hGH dose dependency of GHD children with SGA.

SGA was defined as a birth weight/length below – 2 SD for gestational age compared to the national standard. The data of hGH treated GHD (GH peak <7 ng/ml in two provocative tests) children and Turner syndrome (TS) with SGA. Some characteristics of the 41 prepubertal children (treated with hGH over 2 years) are the following: age: 8.37±3.72 (2.71–15.87) years; sex: boy/girl 18/23; HSDS: −3.49 ±1.0 (between – 1.7 and – 5.56); hGH dose: 0.69± 0.18 (0.4-1.05) IU/kg/w; ΔHSDS/2 years: 0.76±0.74 (between −0.42 and +2.48).

The ΔHSDS was found 0.92±0.77 in 13 children treated with a mean dose ≥0.8 IU/kg per w and 0.68±0.73 in the other 28 children received <0.8 IU/kg per w. The same parameters proved to be 1.2±0.6 and 0.73±0.5 resp. in the younger (<6 years) age (P<0.01). This dose dependency was more significant in the children to be SGA for birth weight: growth response of 15 among 21 was <1.0 ΔHSDS/2 yrs treated with <0.8 IU/kg per w (P<0.01).

These results confirm the previous data of de Zegher et al. (1998), that the great majority of GHD children with SGA need higher than replacement dose of hGH for optimum growth response, probably because of some IGF-I resistance of these children.