Background Short-term administration of growth hormone to childrenwith idiopathic short stature results in increases in growthrate and standard-deviation scores for height. However, theeffect of long-term growth hormone therapy on adult height inthese children is unknown.
Methods We studied 121 children with idiopathic short stature,all of whom had an initial height below the third percentile,low growth rates, and maximal stimulated serum concentrationsof growth hormone of at least 10 µg per liter. The childrenwere treated with growth hormone (0.3 mg per kilogram of bodyweight per week) for 2 to 10 years. Eighty of these childrenhave reached adult height, with a bone age of at least 16 yearsin the boys and at least 14 years in the girls, and pubertalstage 4 or 5. The difference between the predicted adult heightbefore treatment and achieved adult height was compared withthe corresponding difference in three untreated normal or short-staturedcontrol groups.
Results In the 80 children who have reached adult height, growthhormone treatment increased the mean standard-deviation scorefor height (number of standard deviations from the mean heightfor chronologic age) from –2.7 to –1.4. The mean(±SD) difference between predicted adult height beforetreatment and achieved adult height was +5.0±5.1 cm forboys and +5.9±5.2 cm for girls. The difference betweenpredicted and achieved adult height among treated boys was 9.2cm greater than the corresponding difference among untreatedboys with initial standard-deviation scores of less than –2,and the difference among treated girls was 5.7 cm greater thanthe difference among untreated girls.
Conclusions Long-term administration of growth hormone to childrenwith idiopathic short stature can increase adult height to alevel above the predicted adult height and above the adult heightof untreated historical control children.
Source Information
From Stanford University, Stanford, Calif. (R.L.H.); Genentech, South San Francisco, Calif. (K.M.A., J.B.); and Wright State University, Yellow Springs, Ohio (A.R.). Presented in part at the annual meeting of the American Pediatric Society and the Society for Pediatric Research, San Diego, Calif., May 9, 1995.
Address reprint requests to Dr. Hintz at the Department of Pediatrics, Rm. S-302, Stanford University Medical Center, Stanford, CA 94305.
Albertsson-Wikland, K., Aronson, A. S., Gustafsson, J., Hagenas, L., Ivarsson, S. A., Jonsson, B., Kristrom, B., Marcus, C., Nilsson, K. O., Ritzen, E. M., Tuvemo, T., Westphal, O., Aman, J.
(2008). Dose-Dependent Effect of Growth Hormone on Final Height in Children with Short Stature without Growth Hormone Deficiency. J. Clin. Endocrinol. Metab.
93: 4342-4350
[Abstract][Full Text]
Cohen, P., Rogol, A. D., Deal, C. L., Saenger, P., Reiter, E. O., Ross, J. L., Chernausek, S. D., Savage, M. O., Wit, J. M., on behalf of the 2007 ISS Consensus Workshop parti,
(2008). Consensus Statement on the Diagnosis and Treatment of Children with Idiopathic Short Stature: A Summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J. Clin. Endocrinol. Metab.
93: 4210-4217
[Abstract][Full Text]
Hardin, D. S., Kemp, S. F., Allen, D. B.
(2007). Twenty Years of Recombinant Human Growth Hormone in Children: Relevance to Pediatric Care Providers. CLIN PEDIATR
46: 279-286
[Abstract]
Dunkel, L.
(2006). Management of children with idiopathic short stature. Eur J Endocrinol
155: S35-S38
[Abstract][Full Text]
Voss, L. D
(2006). Is short stature a problem? The psychological view. Eur J Endocrinol
155: S39-S45
[Abstract][Full Text]
Rapaport, R., Lee, M. M.
(2006). Idiopathic Short Stature. NEJM
355: 1178-1178
[Full Text]
Allen, D. B.
(2006). Growth Hormone Therapy for Short Stature: Is the Benefit Worth the Burden?. Pediatrics
118: 343-348
[Full Text]
Lee, M. M.
(2006). Clinical practice. Idiopathic short stature.. NEJM
354: 2576-2582
[Full Text]
Han, J. C., Balagopal, P., Sweeten, S., Darmaun, D., Mauras, N.
(2006). Evidence for Hypermetabolism in Boys with Constitutional Delay of Growth and Maturation. J. Clin. Endocrinol. Metab.
91: 2081-2086
[Abstract][Full Text]
Lee, J. M., Davis, M. M., Clark, S. J., Hofer, T. P., Kemper, A. R.
(2006). Estimated Cost-effectiveness of Growth Hormone Therapy for Idiopathic Short Stature. Arch Pediatr Adolesc Med
160: 263-269
[Abstract][Full Text]
Cuttler, L.
(2005). Safety and Efficacy of Growth Hormone Treatment for Idiopathic Short Stature. J. Clin. Endocrinol. Metab.
90: 5502-5504
[Full Text]
Kemp, S. F., Kuntze, J., Attie, K. M., Maneatis, T., Butler, S., Frane, J., Lippe, B.
(2005). Efficacy and Safety Results of Long-Term Growth Hormone Treatment of Idiopathic Short Stature. J. Clin. Endocrinol. Metab.
90: 5247-5253
[Abstract][Full Text]
Stein, M. T., Frasier, S. D., Stabler, B.
(2004). Parent Requests Growth Hormone for Child With Idiopathic Short Stature. Pediatrics
114: 1478-1482
[Full Text]
Ross, J. L., Sandberg, D. E., Rose, S. R., Leschek, E. W., Baron, J., Chipman, J. J., Cassorla, F. G., Quigley, C. A., Crowe, B. J., Roberts, K., Cutler, G. B. Jr.
(2004). Psychological Adaptation in Children with Idiopathic Short Stature Treated with Growth Hormone or Placebo. J. Clin. Endocrinol. Metab.
89: 4873-4878
[Abstract][Full Text]
McElhinney, D. B., Colan, S. D., Moran, A. M., Wypij, D., Lin, M., Majzoub, J. A., Crawford, E. C., Bartlett, J. M., McGrath, E. A., Newburger, J. W.
(2004). Recombinant Human Growth Hormone Treatment for Dilated Cardiomyopathy in Children. Pediatrics
114: e452-e458
[Abstract][Full Text]
Weise, K. L, Nahata, M. C
(2004). Growth Hormone Use in Children with Idiopathic Short Stature. The Annals of Pharmacotherapy
38: 1460-1468
[Abstract][Full Text]
Leschek, E. W., Rose, S. R., Yanovski, J. A., Troendle, J. F., Quigley, C. A., Chipman, J. J., Crowe, B. J., Ross, J. L., Cassorla, F. G., Blum, W. F., Cutler, G. B. Jr., Baron, J.
(2004). Effect of Growth Hormone Treatment on Adult Height in Peripubertal Children with Idiopathic Short Stature: A Randomized, Double-Blind, Placebo-Controlled Trial. J. Clin. Endocrinol. Metab.
89: 3140-3148
[Abstract][Full Text]
Carel, J.-C., Chatelain, P., Rochiccioli, P., Chaussain, J.-L.
(2003). Improvement in Adult Height after Growth Hormone Treatment in Adolescents with Short Stature Born Small for Gestational Age: Results of a Randomized Controlled Study. J. Clin. Endocrinol. Metab.
88: 1587-1593
[Abstract][Full Text]
Yanovski, J. A., Rose, S. R., Municchi, G., Pescovitz, O. H., Hill, S. C., Cassorla, F. G., Cutler, G. B. Jr.
(2003). Treatment with a Luteinizing Hormone-Releasing Hormone Agonist in Adolescents with Short Stature. NEJM
348: 908-917
[Abstract][Full Text]
Modan-Moses, D., Yaroslavsky, A., Novikov, I., Segev, S., Toledano, A., Miterany, E., Stein, D.
(2003). Stunting of Growth as a Major Feature of Anorexia Nervosa in Male Adolescents. Pediatrics
111: 270-276
[Abstract][Full Text]
Maniati-Christidi, M., Livadas, S., Voutetakis, A., Tolis, G., Dacou-Voutetakis, C.
(2003). Human Growth Hormone and Gonadotropin Releasing Hormone Analog Combination Therapy Increases Predicted Height in Short Normal Girls. CLIN PEDIATR
42: 59-65
[Abstract]
Kamp, G A, Waelkens, J J J, de Muinck Keizer-Schrama, S M P F, Delemarre-Van de Waal, H A, Verhoeven-Wind, L, Zwinderman, A H, Wit, J M, Clayton, P E
(2002). High dose growth hormone treatment induces acceleration of skeletal maturation and an earlier onset of puberty in children with idiopathic short stature. Arch. Dis. Child.
87: 215-220
[Abstract][Full Text]
Finkelstein, B. S., Imperiale, T. F., Speroff, T., Marrero, U., Radcliffe, D. J., Cuttler, L.
(2002). Effect of Growth Hormone Therapy on Height in Children With Idiopathic Short Stature: A Meta-analysis. Arch Pediatr Adolesc Med
156: 230-240
[Abstract][Full Text]
Wit, J. M., Rekers-Mombarg, L. T. M.
(2002). Final Height Gain by GH Therapy in Children with Idiopathic Short Stature Is Dose Dependent. J. Clin. Endocrinol. Metab.
87: 604-611
[Abstract][Full Text]
Kaplowitz, P. B.
(2001). If Gonadotropin-Releasing Hormone Plus Growth Hormone (GH) Really Improves Growth Outcomes in Short Non-GH-Deficient Children, Then What?. J. Clin. Endocrinol. Metab.
86: 2965-2968
[Full Text]
Kamp, G. A., Mul, D., Waelkens, J. J. J., Jansen, M., Delemarre-van de Waal, H. A., Verhoeven-Wind, L., Frolich, M., Oostdijk, W., Wit, J. M.
(2001). A Randomized Controlled Trial of Three Years Growth Hormone and Gonadotropin-Releasing Hormone Agonist Treatment in Children with Idiopathic Short Stature and Intrauterine Growth Retardation. J. Clin. Endocrinol. Metab.
86: 2969-2975
[Abstract][Full Text]
Haffner, D., Schaefer, F., Nissel, R., Wuhl, E., Tonshoff, B., Mehls, O., The German Study Group for Growth Hormone Treatmen,
(2000). Effect of Growth Hormone Treatment on the Adult Height of Children with Chronic Renal Failure. NEJM
343: 923-930
[Abstract][Full Text]
Pasquino, A. M., Pucarelli, I., Roggini, M., Segni, M.
(2000). Adult Height in Short Normal Girls Treated with Gonadotropin-Releasing Hormone Analogs and Growth Hormone. J. Clin. Endocrinol. Metab.
85: 619-622
[Abstract][Full Text]
Guyda, H.
(1999). Four Decades of Growth Hormone Therapy for Short Children: What Have We Achieved?. J. Clin. Endocrinol. Metab.
84: 4307-4316
[Full Text]
Vance, M. L., Mauras, N.
(1999). Growth Hormone Therapy in Adults and Children. NEJM
341: 1206-1216
[Full Text]
Voss, L. D
(1999). Short but normal. Arch. Dis. Child.
81: 370-371
[Full Text]
(1999). Long-Term Benefit of Growth Hormone in Children?. JWatch Psychiatry
1999: 20-20
[Full Text]
(1999). Long-Term Benefit of Growth Hormone in Children with Idiopathic Short Stature. JWatch General
1999: 6-6
[Full Text]
Oberfield, S. E.
(1999). Growth Hormone Use in Normal, Short Children -- A Plea for Reason. NEJM
340: 557-559
[Full Text]
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