Growth hormone deficit: Influence of puberty on the response to treatment

• Published in: Anales de Pediatría 2022-03, Vol.96 (3), p.221-229
• Main Authors: María José Sánchez Malo, Juan Hidalgo Sanz, Cristina Hernández Tejedor, María García Ventura, Marta Ferrer Lozano, Jose Ignacio Labarta Aizpún, Antonio de Arriba Muñoz
• Format: Article
• Language: Spanish
• Subjects: Hormona crecimiento; Hormonadecrecimiento humana; Maduración sexual; Pubertad
• ISSN: 2341-2879; 2341-2879

Introduction: Short stature is the most frequent reason for consultation in Pediatric Endocrinology consultations and sometimes requires treatment with growth hormone. The aim of the study was to analyze the response to treatment based on its onset in pubertal or prepubertal stages and to analyze the possible benefit of an early onset. Patients and methods: Longitudinal, retrospective and observational study in 139 patients treated for idiopathic growth hormone deficiency up to adult height. Main variables studied: (a) genetic background: maternal, paternal and genetic height; (b) perinatal history; (c) anthropometry during follow-up and at pubertal onset: weight, height, body mass index; (d) variables during follow-up and at pubertal onset: growth rate, bone age and growth prognosis. Final response variables: adult height, adult height with respect to target height, adult height with respect to initial growth prediction, adult height with respect to initial height at the start of treatment and adult height with respect to height at pubertal onset. Results: Total pubertal gain was 0.84 ± 0.6 SD. 61.9% of the patients started treatment with rhGH in prepuberty. The initiation of treatment in the prepubertal stage and a higher total pubertal gain are correlated with a better final height (P = 0.001 and r = 0.507, P = 0.00, respectively). Furthermore, a longer duration of treatment in pre-puberty is correlated with a better final response (r = 0.328, P = 0.00). Conclusions: The start of treatment in the prepubertal stage and its longer duration during this period are determining factors to achieve a good long-term response. Total pubertal gain was greater in patients who started treatment in the pubertal stage. Resumen: Introducción: La talla baja es motivo de consulta frecuente en Endocrinología Pediátrica, precisando en ocasiones tratamiento con hormona del crecimiento (GH). El objetivo del estudio fue analizar la respuesta al tratamiento en función de su inicio en la etapa puberal o prepuberal y analizar el posible beneficio de un comienzo precoz. Pacientes y métodos: Estudio longitudinal, retrospectivo y observacional en 139 pacientes tratados por déficit de GH idiopático (grave o parcial) hasta talla adulta. Principales variables estudiadas: a) antecedentes familiares: talla materna, paterna y genética; b) antecedentes perinatales; c) antropometría durante el seguimiento y al inicio puberal: peso, talla, índice de masa corporal, y d) variables durante el