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Isolated childhood growth hormone deficiency: a 30-year experience on final height and a new prediction model

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Abstract

Purpose

We aimed to evaluate the near-final height (nFHt) in a large cohort of pediatricpatients with growth hormone deficiency (GHD) and to elaborate a new predictive method of nFHt.

Methods

We recruited GHD patients diagnosed between 1987 and 2014 and followed-up until nFHt. To predict the values of nFHt, each predictor was run in a univariable spline.

Results

We enrolled 1051 patients. Pre-treatment height was −2.43 SDS, lower than parental height (THt) (−1.09 SDS, p < 0.001). The dose of recombinant human GH (rhGH) was 0.21mg/kg/week at start of treatment. nFHt was −1.08 SDS (height gain 1.27 SDS), higher than pre-treatment height (p < 0.001) and comparable to THt. 1.6% of the patients were shorter than −2 SDS from THt. The rhGH dose at nFHt was 0.19 mg/kg/week, lower than at the start (p < 0.001). The polynomial regression showed that nFHt was affected by gender, THt, age at puberty, height at puberty, age at the end of treatment (F = 325.37, p < 0.0001, R2 87.2%).

Conclusion

This large national study shows that GHD children can reach their THt. The rhGH/kg/day dose significantly decreased from the start to the end of the treatment. Our model suggests the importance of a timely diagnosis, possibly before puberty, the beneficial effect of long-term treatment with rhGH, and the key-role of THt. Our prediction model has a very acceptable error compared to the majority of other published studies.

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Acknowledgements

The Members of the Study Group on Physiopathology of growth processes of ISPED are as follows: Bruzzi Patrizia (Modena), Capalbo Donatella (Napoli), Fatti Letizia Maria (Milano) (0000-0002-1219-8953), Luongo Caterina (Napoli), Moro Mirella (Milano) (0000-0003-1645-547X), Pellegrin Maria Chiara (Trieste), Pepe Giorgia (Messina), Predieri Barbara (Modena), Sangiorgio Arianna (Milnao), Salvatoni Alessandro (Varese), Sartori Chiara (Reggio Emilia), Timpanaro Tiziana (Catania), Trombatore Jessica (Messina), Zucchini Stefano (Bologna), Zuccotti Gianvincenzo (Milano). The listed members are considered as authors of the paper.

Author information

Authors and Affiliations

  1. Giovanni XXIII Children’s Hospital, AOU Policlinico di Bari, piazza G.Cesare 11, Bari, Italy

    Antonella Lonero & Maurizio Delvecchio

  2. Department of Biomedical Science and Human Oncology, University of Bari “Aldo Moro”, Bari, Italy

    Massimo Giotta & Paolo Trerotoli

  3. Specialty School of Paediatrics - Alma Mater Studiorum, University of Bologna, Bologna, Italy

    Giulia Guerrini

  4. Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy

    Valeria Calcaterra

  5. Pediatric Department, “V. Buzzi” Children’s Hospital, University of Milan, Milan, Italy

    Valeria Calcaterra & Chiara Mameli

  6. Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Elena Galazzi

  7. Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy

    Lorenzo Iughetti

  8. Department of Pediatric Endocrinology, Unit of Pediatrics, University of Bologna, Bologna, Italy

    Alessandra Cassio

  9. Department of Human Pathology of Adulthood and Childhood, Unit of Pediatrics, University of Messina, Messina, Italy

    Gabriela Malgorzata Wasniewska

  10. Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy

    Gianluca Tornese

  11. Department of Translational Medical Sciences, Paediatric Endocrinology Unit, University of Naples ‘Federico II’, Naples, Italy

    Mariacarolina Salerno

  12. Department of Women’s and Children’s Health, G. Salesi Hospital, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy

    Valentino Cherubini

  13. Department of Paediatrics, “G Rodolico Hospital”, University of Catania, Catania, Italy

    Manuela Caruso Nicoletti

  14. Department of Mother and Child, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy

    Maria Elisabeth Street

  15. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Maria Elisabeth Street

  16. Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Anna Grandone

  17. Unit of Pediatrics, Department of Maternal and Child Health, Carlo Poma Hospital, ASST-Mantova, Mantua, Italy

    Claudio Giacomozzi

  18. Department of Biomedical Sciences and Human Oncology, Paediatric Unit, University of Bari “A. Moro”, Bari, Italy

    Maria Felicia Faienza

  19. SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico “A. Cao”, ASSL Cagliari, Novara, Italy

    Chiara Guzzetti

  20. SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy

    Simonetta Bellone

  21. Anna Meyer Children’s Hospital, Florence, Italy

    Maria Parpagnoli

  22. Ambulatorio di Auxologia ed Endocrinologia pediatrica, S.C. Pediatria, Ospedale Pediatrico “Filippo Del Ponte”, ASST Sette Laghi, Varese, Italy

    Gianluca Musolino

  23. Department of Health Promotion, Maternal and Infantile Care, Department of Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Palermo, Italy

    Maria Cristina Maggio

  24. Il bambino e il suo pediatra-Onlus, Novara, Italy

    Mauro Bozzola

  25. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

    Alessandra Cassio

Authors
  1. Antonella Lonero
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  2. Massimo Giotta
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  3. Giulia Guerrini
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  4. Valeria Calcaterra
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  5. Elena Galazzi
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  6. Lorenzo Iughetti
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  7. Alessandra Cassio
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  8. Gabriela Malgorzata Wasniewska
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  9. Chiara Mameli
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  10. Gianluca Tornese
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  11. Mariacarolina Salerno
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  12. Valentino Cherubini
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  13. Manuela Caruso Nicoletti
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  14. Maria Elisabeth Street
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  15. Anna Grandone
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  16. Claudio Giacomozzi
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  17. Maria Felicia Faienza
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  18. Chiara Guzzetti
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  19. Simonetta Bellone
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  20. Maria Parpagnoli
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  21. Gianluca Musolino
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  22. Maria Cristina Maggio
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  23. Mauro Bozzola
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  24. Paolo Trerotoli
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  25. Maurizio Delvecchio
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Study Group on Physiopathology of growth processes of ISPED

Corresponding author

Correspondence to Maurizio Delvecchio.

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None to declare. We would like to thank patients and their parents for joining the study.

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Members of the Study Group on Physiopathology of growth processes of ISPED are listed in the acknowledgements section.

Supplementary Information

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40618_2022_1808_MOESM1_ESM.pptx

Supplementary file1 Scatter plot and linear trend line to shown relation between real values and estimated values by validation process to predict final height (PPTX 62 KB)

40618_2022_1808_MOESM2_ESM.pptx

Supplementary file2 Scatter plot and linear trend line to shown relation between real values and estimated values by validation process to predict final SDS (PPTX 56 KB)

Supplementary file3 (DOCX 116 KB)

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Lonero, A., Giotta, M., Guerrini, G. et al. Isolated childhood growth hormone deficiency: a 30-year experience on final height and a new prediction model. J Endocrinol Invest 45, 1709–1717 (2022). https://doi.org/10.1007/s40618-022-01808-4

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