BSPED2009 Poster Presentations (1) (38 abstracts)
Defining Criteria for Poor Responders to Growth Hormone (GH) in Short Children Born Small for Gestational Age (SGA)
A Omokanye 1 , I Onyekpe 2 , L Patel 2 , I Banerjee 2 , R Amin 2 , C Hall 2 & P Clayton 2
1Endocrine Science Research Group, University of Manchester, Manchester, UK; 2Endocrinology, Royal Manchester Children’s Hospital, Manchester, UK.
An estimated 5% of all newborns are born SGA (weight less than −2SD at birth), with 10% failing to catch up and becoming eligible for GH treatment. Not all children respond to GH, but the criteria for determining a non-responder have not been clearly defined. We have therefore evaluated first year growth performance of short SGA children treated with GH in The Growth Clinic, Manchester. Clinical and auxological data were collected retrospectively from the case records of 57 SGA patients. In our cohort, regression analysis identified starting GH dose as the most significant variable influencing first year growth response (R2=7.2%, P=0.06). Age also influenced response (see figure). The lower line of the figure approximately represents the 10th percentile. We propose that a height SDS increment below this line represents a clinically insignificant response (e.g. Δheight SDS < 0.2 for a child age 5).
It is important to define what is an acceptable treatment response at the initiation of GH, so that decisions can be made promptly to discontinue GH and/or consider alternative treatments.
Figure: Relationship between first-year growth performance and age. Regression line with 80% confidence intervals shown.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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