Endocrine Abstracts (2017) 51 P044 | DOI: 10.1530/endoabs.51.P044

Changing patterns of growth in children with prader-willi syndrome

Georgia Irene Neophytou1, Mikaela Frixou1, M Guftar Shaikh2 & Andreas Kyriakou2


1University of Glasgow, Glasgow, UK; 2Department of Paediatric Endocrinology, Royal Hospital For Children, Glasgow, UK.


Introduction: Children with Prader-Willi syndrome (PWS) show alterations in infantile, childhood and pubertal growth. Growth Hormone (GH) therapy is recommended due to reported improvements in height velocity (HV) and body composition.

Methods: Height SDS (HSDS), BMISDS and HVSDS of children attending a dedicated PWS clinic, 2000–2017, were analysed. To identify changes in growth we compared growth parameters between 2000–2012 and 2013–2017. In 21 children who received GH (median age at GH start 4.92 years (2.27,8.1), consecutive measurements were available at −1, 0,+1 and +2 years from GH start.

Results: Overall, 60 children (31F/29M) were included. Three phases of growth after the age of 1 year were identified: 1–5 years, with acceleration in both HSDS (r 0.305, P<0.0001) and BMISDS (r 0.595, P<0.0001); 6–12 years, with stabilisation in both HSDS (r 0.063, P 0.417) and BMISDS (r −0.154, P 0.087); and 13–18 years, with deceleration in HSDS (r −0.389, P<0.0001) and unchanged BMISDS (r 0.051, P 0.647). At age 5, children in 2013–2017 (n 12) had higher HSDS [median −0.08 (−1.74,1.54) vs −1.04 (−4.16,0.5)] than those in 2000–2012 (n 18) (P 0.03). At age 12, children in 2013–2017 (n 5) had higher HSDS [median, 1.13 (−0.62,1.59) vs −1.35 (−4.27,0.23)] (P 0.027) and lower BMISDS [median 1.05 (−0.13,2.14) vs 2.44 (0.13,4.3)] (P 0.032) than those in 2000–2012 (n 11). After 2 years on GH, median HSDS improved from −1.43 (−4.59,0.95) to −0.11 (−3.53,1.57) (P<0.0001) and median HVSDS from 0.62 (−5.9,4.17) to 2.8 (−2.2,5.2) (P 0.027). BMISDS was unchanged.

Age1 year5 years12 years16, 17 years
Number32301631
HSDS−1.82 (−3.99,−0.08)−0.76 (−4.16,2.25)*−0.59 (−4.27,1.59)−2.66 (−4.27,−0.64)**
BMISDS−0.83 (−3.27,1.85)2.51 (−2.36,5.63)*1.94 (−0.13,4.3)2.52 (−1.5,4.18)
*P<0.0001 vs age 1.**P<0.0001 vs age 5 and age 12.

Conclusion: We were able to delineate 3 distinct phases of growth in PWS. Changes in our clinical practice have led to improvements in both height and BMI. GH therapy was associated with an increase in height and stabilisation of BMI.

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