Height velocity targets for the first year in response to recombinant human growth hormone (rhGH) treatment in pre-pubertal Growth Hormone Deficiency (GHD) children

doi:10.19538/j.ek2017120612

Abstract：Objective To describe height velocity in pre-pubertal Growth Hormone Deficiency (GHD) children without recombinant human growth hormone (rhGH) treatment and explore the height velocity targets for the first year in response to rhGH treatment.Methods Analyze retrospectively the height velocity data without (HV0) and one year after (HV1) rhGH treatment in physiologic dose [0.7 U/(kg· w)] in pre-pubertal GHD children above 3 years old who were diagnosed from Jan,2000 to Dec,2009 in our hospital.The GHD patients who were included for calculation of HV0 had peak GH value in GH provocative test less than 7 ng/ml.HV0 was calculated according to age (HV0-CA,342 patients) and bone age (HV0-BA,257 patients) respectively.According to the peak GH value in GH provocative test,the patients who were included for calculation of HV1 were divided into GHD-1 group(＜ 0.33 nmol/L,140 patients) and GHD-2 group (7.0 ～ 9.9 μg/L,33 patients).Results Within every bone age group,GHD-1 group had significantly higher HV1 than GHD-2 group(P＜0.05),11.0(10.5-11.5) cm/a(n =34) vs.9.9(9.1-10.8) cm/a(n =6) when bone age was less than 3 years,10.4(9.8-10.9) cm/a(n =48) vs.8.8(8.3 ～9.2) cm/a(n =8) when bone age was between 3 to 5 years,and 9.5(9.1-9.9) cm/a(n =58) vs.8.5(8.0-9.1) cm/a(n =19) when bone age was between 6 to 10 years.The mean HV1 of GHD-2 was very close to the 25th percentile (P25) of GHD-1 group.They both were significantly higher than HV0-BA.Conclusion The recommended height velocity target for the first year after rhGH treatment in prepubertal GHD children is the P25 of HV1 of GHD-1 group.It should be at least 9.9 cm/a,8.7 cm/a and 8.3 cm/a when the bone age is less than 3 years,3 to 5 years and 6 to 10 years,respectively.