Endocrine Abstracts

JOINT2071

Background: Growth hormone (GH) therapy is widely used among children with short stature, and in Montenegro it is approved for five indications (GH deficiency (GHD), Turner Syndrome (TS), being born small for gestational age with failure to attain normal growth (SGA), Prader-Willi Syndrome (PWS) and chronic renal disease (CKD)). This study aims to present the structure and outcomes of children treated with growth hormone in Montenegro.

Methods: This cross-sectional retrospective study included children (age < 18 years) with short stature treated with GH between January 2005 and Decembre 2024, followed at the Institute for Children’s Diseases, Clinical centre of Montenegro (centre of reference).

Results: A total of 221 children received GH therapy during the observed period of whom 52% (n=115), were boys. Clinical indications were GHD (n=69, 31.2%), SGA (n=123, 55.7%), CKD (n=12, 5.4%), TS (n=15, 6.8%), and PWS (n=2, 0.9%). Median of age at GH initiation was 9.7 years. Mean age at GH initiation based on indications were 11.8 years (±3.7) for GHD, 8.3 years (±3.2) for SGA, 7.0 years for CKD (±5.4), 8.4 years (±3.1) for TS and 5.4 years (±1.4) for TS. Mean height SDS at baseline was -2.89 ± 0.72, comparable among all groups but worse for PWS. The youngest patient in our cohort was 17 months old, and the oldest at the GH initiation was 16.7 years. The responses after 3 years persisted (Mean height SD gain=1.1±0.8).

Conclusion: Being born small for gestational age with failure to attain normal growth is the most common indication from treatment in our country, which is inconsistent with international surveillance data, where GHD is predominant. Our results also point out the need to develop national growth charts to define appropriate birth length and weight due to gestational age.