Home Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
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Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades

  • Michael B. Ranke EMAIL logo , Roland Schweizer and Gerhard Binder
Published/Copyright: October 17, 2018
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 31 Issue 11

Abstract

Background

Children with non-acquired (na) growth hormone deficiency (GHD) diagnosed over decades in one center may provide perspective insight.

Methods

naGHD is divided into idiopathic GHD (IGHD), GHD of known cause (cGHD) and GHD neurosecretory dysfunction (NSD); time periods: <1988 (I); 1988–1997 (II); 1998–2007 (III); 2008–2015 (IV). Descriptive analyses were performed at diagnosis and during first year GH treatment.

Results

Patients (periods, N): I, 87; II, 141; III, 356; IV, 51. In cGHD (all), age, maximum GH, insulin-like growth factor-I (IGF-I), and insulin-like growth factor-binding protein-3 (IGFBP-3) (5.1 years, 3.6 μg/L, −5.3 standard deviation score [SDS], −3.7 SDS) were lower than in IGHD (all) (6.8 years 5.8 μg/L, −2.5 SDS, −1.0 SDS), but not height (−3.1 vs. −3.2 SDS). Characteristics of NSD were similar to that of IGHD. Patients with IGHD – not cGHD – diagnosed during 2008–2015 (IV) were the youngest with most severe GHD (maxGH, IGF-I, IGFBP-3), and first year height velocity (HV) and ∆ IGF-I (10.5 cm/year, 4.0 SDS) but not ∆ height SDS were the highest on recombinant human growth hormone (rhGH) (27 μg/kg/day).

Conclusions

Although during 1988–2007 patient characteristics were similar, the recently (>2008) stipulated more stringent diagnostic criteria – HV before testing, sex steroid priming, lower GH cut-off – have restricted diagnoses to more severe cases as they were observed before the rhGH era.

Keywords: diagnosis; growth hormone deficiency (GHD); long-term observations; short-term response

Acknowledgments

The authors acknowledge the essential contribution for the care of the patients by Prof. Jürgen R Bierich (+), Prof. Dietrich Schönberg (+), PD Klaus Rager, Prof. Derek Gupta (+), Prof. Hans Moeller (+), PD Andrea Attanasio, Prof. Werner F Blum and Prof. Hartmut A Wollmann, The authors acknowledge the support with the data analysis by Felice Serra.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  6. Disclosure statement: MBR is a member of the Pfizer iGRO advisory group and has received speakers’ honoraria from Pfizer, Sandoz. GB is a member of the advisory board of Ferring, Novo Nordisk, Pfizer and has received speakers’ honoraria from Merck-Serono, Lilly, Ipsen, Novo Nordisk, Sandoz, Ferring. RS has received speakers’ honoraria from Novo Nordisk, Sandoz and Lilly.

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Received: 2018-01-15
Accepted: 2018-09-03
Published Online: 2018-10-17
Published in Print: 2018-11-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

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  13. Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
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https://doi.org/10.1515/jpem-2018-0025
Keywords for this article
diagnosis; growth hormone deficiency (GHD); long-term observations; short-term response

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
  4. Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
  5. Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
  6. Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states
  7. High urate concentration is associated with elevated blood pressure in schoolchildren
  8. The association of hs-CRP and fibrinogen with anthropometric and lipid parameters in non-obese adolescent girls with polycystic ovary syndrome
  9. Leptin and adiposity as mediators on the association between early puberty and several biomarkers in European adolescents: the HELENA Study
  10. Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
  11. Thyroid dysfunction in children with leukemia over the first year after hematopoietic stem cell transplantation
  12. Morning vs. bedtime levothyroxine administration: what is the ideal choice for children?
  13. Basal characteristics and first year responses to human growth hormone (GH) vary according to diagnostic criteria in children with non-acquired GH deficiency (naGHD): observations from a single center over a period of five decades
  14. The prevalence and volumetry of pituitary cysts in children with growth hormone deficiency and idiopathic short stature
  15. SHOX gene deletion screening by FISH in children with short stature and Madelung deformity and their characteristics
  16. FGFR3-related hypochondroplasia: longitudinal growth in 57 children with the p.Asn540Lys mutation
  17. Case Reports
  18. A variable course of Cushing’s disease in a 7 year old: diagnostic dilemma
  19. Severe hyperchylomicronemia in two infants with novel APOC2 gene mutation
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