Details

Autor(en) / Beteiligte

• Cohen, Pinchas
• Rogol, Alan D.
• Weng, Wayne
• Kappelgaard, Anne-Marie
• Rosenfeld, Ron G.
• Germak, John

Titel

Efficacy of IGF-based growth hormone (GH) dosing in nonGH-deficient (nonGHD) short stature children with low IGF-I is not related to basal IGF-I levels

Ist Teil von

• Clinical endocrinology (Oxford), 2013-03, Vol.78 (3), p.405-414

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2013

Quelle

Wiley Online Library All Journals

Beschreibungen/Notizen

• Summary Objective Weight‐based GH dosing is the standard for treating children with short stature. The current study validates the usefulness of IGF‐based GH dosing for GH therapy in nonGH‐deficient (nonGHD) children and its relationship with pretreatment serum IGF‐I concentration. Design and Patients In this twelve‐month, open‐label, randomized controlled study, 151 nonGHD (based on GH‐stimulation tests), prepubertal children with short stature and IGF‐I levels ≤ 33rd percentile [–0·44 standard deviation score (SDS)] were randomly assigned to receive GH (dose based on IGF‐I titration algorithm; n = 114) or to observation (n = 37). GH dose (initially 40 μg/kg/d) was adjusted every 3 months to achieve an IGF‐I SDS in the upper normal range (66–99th percentile). Measurements and Results In treated children, mean height SDS (HSDS) increased from −2·5 at baseline to −1·7 at 12 months and mean IGF‐I SDS increased from −1·7 to 0·1. These parameters remained unchanged in untreated children. There was no relationship between change in HSDS (ΔHSDS) and degree of IGF‐I deficiency at baseline. No safety problems were observed. Both groups had a similar advance in bone age. At the end of study, ΔHSDS in treated children showed a positive correlation with IGF‐I SDS, but not with GH dose [mean 59 μg/kg/d (range 29–92)], basal IGF‐I SDS or 1‐month IGF parameters. Conclusions In nonGHD subjects with short stature and serum IGF‐I concentrations within and below the lower third of normal, adjusting GH dose to achieve an IGF‐I level in the upper normal range resulted in a significant increase in HSDS, regardless of basal IGF‐I levels.