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Growth hormone dose-dependent pubertal growth: a randomized trial in short children with low growth hormone secretion
Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
Pediatrics Unit, Department of Clinical Sciences, Umeå University, Sweden.
Pediatrics Unit, Department of Clinical Sciences, Umeå University, Sweden.
Department of Pediatrics, Halmstad Hospital, Sweden.
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2014 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 82, no 3, 158-170 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/AIMS: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i.e. idiopathic isolated GH deficiency.

METHODS: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH 33 µg/kg/day for ≥1 year. They were randomized to receive 67 µg/kg/day (GH(67)) given as one (GH(67×1); n = 35) or two daily injections (GH(33×2); n = 36), or to remain on a single 33 µg/kg/day dose (GH(33×1); n = 40). Growth was assessed as heightSDSgain for prepubertal, pubertal and total periods, as well as AHSDS versus the population and the midparental height.

RESULTS: Pubertal heightSDSgain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33×1), 0.41, p < 0.05). AHSDS was greater on GH(67) (GH(67×1), -0.84; GH(33×2), -0.83) than GH(33) (-1.25, p < 0.05), and heightSDSgain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target heightSDS.

CONCLUSION: Pubertal heightSDSgain and AHSDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once- and twice-daily GH(67) regimens.

Place, publisher, year, edition, pages
2014. Vol. 82, no 3, 158-170 p.
National Category
URN: urn:nbn:se:uu:diva-238294DOI: 10.1159/000363106ISI: 000345448500003PubMedID: 25170833OAI: oai:DiVA.org:uu-238294DiVA: diva2:770791
Available from: 2014-12-11 Created: 2014-12-11 Last updated: 2015-01-05Bibliographically approved

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Gustafsson, JanJonsson, BjörnTuvemo, Torsten
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