The Effects of Growth Hormone on Bone Age Progression in
Children Deficient in hGH Pre-Puberty
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Darendeliler, Feyza; Ranke, Michael B.;
Bakker, Bert; Lindberg, Anders; Cowell, Christopher T.; Albertsson-Wikland,
Kerstin; Reiter, Edward O.; Price, David A.
Bone Age Progression during the
First Year of Growth Hormone Therapy in Pre-Pubertal Children with Idiopathic
Growth Hormone Deficiency, Turner Syndrome or Idiopathic Short Stature, and in
Short Children Born Small for Gestational Age: Analysis of data from KIGS
(Pfizer International Growth Database)
Hormone Research, 2005, Vol. 63 Issue
1, p40-47, 8p; DOI: 10.1159/000082872; (AN 15751634
The purpose of this
research was to study the effects of growth hormone (GH) therapy on skeletal
maturation in children with growth disorders. The progression of bone age (BA)
was studied during the first year of GH treatment in pre-pubertal children with
idiopathic GH deficiency (GHD), Turner syndrome (TS) or idiopathic short stature
(ISS), and in short pre-pubertal children born small for gestational age (SGA).
All patients included in the study were enrolled in Pfizer International
Growth Database and were being treated with recombinant human growth hormone (rhGH).
Cross-sectional data was analyzed on 2,209 short children with idiopathic GHD,
694 with TS, 569 with ISS and 153 with SGA. The males and females were not
differentiated and ranged in age from 7.6 – 9.7 years. The study also analyzed
longitudinal data on 308 children with idiopathic GHD, 99 with TS, 57 with ISS
and 29 with SGA. That included 208 girls and 285 boys, ranging in age from 6.8 –
10 years.
Bone age was assessed at baseline and after 1 year of GH
therapy. Bone age in normal children is generally equal to chronological age,
although there can be considerable variation in bone age progression. The
pattern of skeletal maturation in children with growth disorders differs from
the norm due to variety of factors.
In the analysis of the available
cross-sectional data, bone age progressed at a normal rate (1 year/1 year) in
children with GHD, TS and SGA during the first year of GH treatment. Children
with ISS experienced a higher rate (1.2 years/1 year). The longitudinal data
provided information on bone age development one year before, at the onset and
for the first year of GH treatment. In all the children the progression of bone
age in the year prior and at the onset was less than 1 year/1 year and increased
to the normal range after the first year of GH treatment in all four diagnostic
groups. In any of the data there was no consistent effect of the GH dose on bone
age progression. Progression of bone age was also not correlated with the
baseline growth measurements.
The researchers concluded that progression
of bone age appears to be normal in patients receiving GH in these diagnostic
groups, at least over the first year of treatment in pre-puberty.
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