Endocrine Abstracts

JOINT1282

Background: treatment with growth hormone (GH) has been approved by many countries for short children born small for gestational age (SGA) with no postnatal growth recovery. To date, optimization of the efficacy of GH treatment has not been achieved in SGA patients.

Aim: to investigate the impact of GH therapy on growth trajectory (GT) and adult height (AH) in children born SGA and to identify factors influencing the efficacy of GH therapy in terms of height gain (HG).

Methods: the study population consisted of 38 SGA children (20 M, 18 F) length without postnatal growth recovery and treated with GH for at least 5 years (mean age at GH start: 7. 65± 3. 26 years; mean height (H): -3. 05±0. 55 SDS) and followed in our Center between 2010 and 2023. Clinical and anthropometric data [age, bone age, H (SDS), weight (SDS), BMI (SDS), SG and delta H -target height (H-TH)] at the start (T0), during GH treatment [at 1 (T1) and 2 years (T2) of therapy, during puberty onset (P0), first (P1) and second year (P2) of puberty] and at the reaching of AH were collected.

Results: HG increased during the first years of GH treatment (mean H at T1 and T2 were -2. 47±0. 55 SD and -2. 07±0. 57 SDS respectively). H at P0 was -1. 89±0. 76 SDS, at P1 it was -1. 61±0. 84 SDS and at P2 it was -1. 50±0. 78 SD. HG resulted greater in males (1. 21±0. 96 SDS) than females (0. 53±0. 49 SD; P < 0. 005). Mean total HG (THG) was 0. 95±0. 87 SDS. Delta H-TH reduced from the start of therapy until the first two years of puberty: H-TH was -1. 63±0. 74 SDS at T0, -1. 03±0. 77 SDS at T1, -0. 66±0. 87 SDS at T2, -0. 10±1. 07 SDS at P1, and -0. 01±1. 13 SDS at P2. However, AH resulted reduced (-2. 11±0. 88 SDS), although within the TH range in 83% of patients. Only 3 patients had an AH below the lower limit of TH. AH was higher in males than females (-1. 70±0. 85 SDS vs -2. 77 ± 0. 39 SDS; P < 0. 005). HG during T1, H at T0 and at P0 did not significantly influence AH.

Conclusions: GH treatment improves GT in SGA children. AH results within TH limits in the majority of patients, even in cases with delayed start of therapy. Sex and timing of GH initiation can influence AH in SGA children. Early selection of SGA patients for GH therapy could further improve their GT.