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Efficacy of long-term growth hormone therapy in short children with reduced growth hormone biological activity

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Abstract

Aim: The optimal GH regimen, in terms of cost-effectiveness, in children with normal GH immunoreactivity but reduced bioactivity is still debated. Methods: In 12 GH-deficient (GHD) and 12 bioinactive GH children undergoing GH treatment we evaluated the increase in growth velocity, the difference between target height and final stature and the incremental cost-effectiveness ratio. Results: We found a significant (p<0.05) increase in growth velocity in both groups during the first year of GH treatment (non-GHD: from −1.7 to 5.4 SDS; GHD: from −1.46 to 4.74 SDS). There was no statistically significant variation between the two groups in the difference between final height and target height. We did not find any significant difference in cost/height gain between GHD (1925.28±653.15 euro) and bioinactive GH children (1639.55±631.44 euro). There were also no significant differences in cost/year of therapy between GHD (12347.68±2018.1 euro) and bioinactive GH children (11355.08±1747.61 euro). Conclusion: In children with reduced GH biological activity, confirmed by the increase of serum IGF-I levels during generation test, the cost of GH treatment is justified by the positive results obtained in growth and adult height as in classical GHD patients.

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References

  1. Strasburger CJ, Bidlingmaier M. How robust are laboratory measures of growth hormone status? Horm Res 2005, 64(Suppl): 1–5.

    Article  CAS  PubMed  Google Scholar 

  2. Popii V, Baumann G: Laboratory measurement of growth hormone. Clin Chim Acta 2004, 350: 1–16.

    Article  CAS  PubMed  Google Scholar 

  3. Wood P. Growth hormone: its measurement and the need for assay harmonization. Ann Clin Biochem 2001, 38: 471–82.

    Article  CAS  PubMed  Google Scholar 

  4. Binder G, Benz MR, Elmlinger M, Pflaum CD, Strasburger CJ, Ranke MB. Reduced human growth hormone (hGH) bioactivity without a defect of the GH-1 gene in three patients with rhGH responsive growth failure. Clin Endocrinol (Oxf) 1999, 51: 89–95.

    Article  CAS  Google Scholar 

  5. Kowarski AA, Schneider J, Ben-Galim E, Welden VV, Daughaday WH. Growth failure with normal serum RIA-GH and low somatomedin activity: somatomedin restoration and growth acceleration after exogenous GH. J Clin Endocrinol Metab 1978, 47: 461–4.

    Article  CAS  PubMed  Google Scholar 

  6. Lewis MD, Horan M, Millar DS, et al. A novel dysfunctional growth hormone variant (Ile179Met) exhibits a decreased ability to activate the extracellular signal-regulated kinase pathway. J Clin Endocrinol Metab 2004, 89: 1068–75.

    Article  CAS  PubMed  Google Scholar 

  7. Valenta LJ, Sigel MB, Lesniak MA, et al. Pituitary dwarfism in a patient with circulating abnormal growth hormone polymers. N Engl J Med 1985, 312: 214–7.

    Article  CAS  PubMed  Google Scholar 

  8. Hayek A, Peake GT, Greenberg RE. A new syndrome of short stature due to biologically inactive but immunoreactive growth hormone. Pediatr Res 1978, 12: 413–13.

    Article  Google Scholar 

  9. Rudman D, Kutner MH, Blackston RD, Cushman RA, Bain RP, Patterson JH. Children with normal-variant short stature: treatment with human growth hormone for six months. N Engl J Med 1981, 305: 123–31.

    Article  CAS  PubMed  Google Scholar 

  10. Frazer T, Gavin JR, Daughaday WH, Hillman RE, Weldon W. Growth hormone-dependent growth failure. J Pediatr 1982, 101: 12–5.

    Article  CAS  PubMed  Google Scholar 

  11. Plotnick LP, Van Meter QL, Kowarski AA. Human growth hormone treatment of children with growth failure and normal growth hormone levels by immunoassay: lack of correlation with somatomedin generation. Pediatrics 1983, 71: 324–17.

    CAS  PubMed  Google Scholar 

  12. Bright GM, Rogol AD, Johanson AJ, Blizzard RM. Short stature associated with normal growth hormone and decreased somatomedin-C concentrations: response to exogenous growth hormone. Pediatrics 1983, 71: 576–80.

    CAS  PubMed  Google Scholar 

  13. Travaglino P, Buzi F, Meazza C, et al. Response to long-term growth hormone therapy in short children with reduced GH bioactivity. Horm Res 2006, 66: 189–94.

    Article  CAS  PubMed  Google Scholar 

  14. Albertsson-Wikland K, Aronson AS, Gustafsson J, et al. Dose-dependent effect of growth hormone on final height in children with short stature without growth hormone deficiency. J Clin Endocrinol Metab 2008, 93: 4342–50.

    Article  CAS  PubMed  Google Scholar 

  15. Juul A, Bang P, Hertel NT, et al. Serum insulin-like growth factor-I in 1030 healthy children, adolescents, and adults: relation to age, sex, stage of puberty, testicular size, and body mass index. J Clin Endocrinol Metab 1994, 78: 744–52.

    CAS  PubMed  Google Scholar 

  16. Juul A, Dalgaard P, Blum WF, et al. Serum levels of insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) in healthy infants, children, and adolescents: the relation to IGF-I, IGF-II, IGFBP-1, IGFBP-2, age, sex, body mass index, and pubertal maturation. J Clin Endocrinol Metab 1995, 80: 2534–42.

    CAS  PubMed  Google Scholar 

  17. Tanner JM, Whitehouse RH. Clinical longitudinal standards for height, weight, height velocity, and stages of puberty. Arch Dis Child 1976, 51: 170–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Schwarze CP, Wollmann HA, Binder G, Ranke MB. Short-term increments of insulin-like growth factor I (IGF-I) and IGF-binding pretein-3 predict the growth response to growth hormone (GH) therapy in GH-sensitive children. Acta Paediatr Suppl 1999, 88: 200–8.

    Article  CAS  PubMed  Google Scholar 

  19. Wit J-M. Growth Hormone Treatment of Idiopathic Short Stature in KIGS. In: Ranke MB, Wilton P eds. Growth hormone therapy in KIGS — 10 years’ experience. Heidelberg, Leipzig: Johann Ambrosius Barth Verlag. 1999, 225–43.

    Google Scholar 

  20. GH Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: Summary Statement of the GH Research Society. J Clin Endocrinol Metab 2000, 85: 3990–3.

    Google Scholar 

  21. Cotterill AM, Camacho-Ubner C, Dunquesnoy P, Savage MO. Changes in serum IGF-I and IGFBP-3 concentrations during the IGF-I generation test performed prospectively in children with short stature. Clin Endocrinol (Oxf) 1998, 48: 719–24.

    Article  CAS  Google Scholar 

  22. Spiliotis BE, Alexandrides TK, Karystianos C, et al. The insulin-like growth factor-I (IGF-I) generation test as an indicator of growth hormone status. Hormones (Athens) 2009, 8: 117–28.

    Article  Google Scholar 

  23. Tanaka T, Shiu RP, Gout PW, Beer CT, Noble RL, Friesen HG. A new sensitive and specific bioassay for lactogenic hormones: measurement of prolactin and growth hormone in human serum. J Clin Endocrinol Metab 1980, 51: 1058–63.

    Article  CAS  PubMed  Google Scholar 

  24. Bozzola M, Zecca M, Locatelli F, et al. Evaluation of growth hormone bioactivity using the Nb2 cell bioassay in children with growth disorders. J Clin Endocrinol Metab 1998, 21: 765–70.

    CAS  Google Scholar 

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Correspondence to Mauro Bozzola.

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Pagani, S., Meazza, C., Laarej, K. et al. Efficacy of long-term growth hormone therapy in short children with reduced growth hormone biological activity. J Endocrinol Invest 34, 366–369 (2011). https://doi.org/10.1007/BF03347461

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