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Growth hormone (GH) dosing during catch-up growth guided by individual responsiveness decreases growth response variability in prepubertal children with GH deficiency or idiopathic short stature.

Kriström, Berit; Aronson, A Stefan; Dahlgren, Jovanna; Gustafsson, Jan; Halldin, Maria; Ivarsson, Sten LU ; Nilsson, Nils-Eric LU ; Svensson, Johan LU ; Tuvemo, Torsten and Albertsson-Wikland, Kerstin (2009) In Journal of Clinical Endocrinology and Metabolism Nov 11. p.483-490
Abstract
Context: Weight-based growth hormone (GH) dosing results in a wide variation in growth response in children with GH deficiency (GHD) or idiopathic short stature (ISS). Objective: The hypothesis tested was whether individualized GH doses, based on variation in GH responsiveness estimated by a prediction model, reduced variability in growth response around a set height target compared with a standardized weight-based dose. Setting: 153 short prepubertal children diagnosed with isolated GHD or ISS (n=43) and >/=1 SDS below mid-parental height standard deviation score(MPHSDS) were included in this 2-year multicenter study. Intervention: The children were randomized to either a standard (43 microg/kg/d) or an individualized GH dose (17-100... (More)
Context: Weight-based growth hormone (GH) dosing results in a wide variation in growth response in children with GH deficiency (GHD) or idiopathic short stature (ISS). Objective: The hypothesis tested was whether individualized GH doses, based on variation in GH responsiveness estimated by a prediction model, reduced variability in growth response around a set height target compared with a standardized weight-based dose. Setting: 153 short prepubertal children diagnosed with isolated GHD or ISS (n=43) and >/=1 SDS below mid-parental height standard deviation score(MPHSDS) were included in this 2-year multicenter study. Intervention: The children were randomized to either a standard (43 microg/kg/d) or an individualized GH dose (17-100 microg/kg/d). Main outcome measure: Deviation of HeightSDS from individual MPHSDS (diffMPHSDS). The primary endpoint was difference in the range of 'diffMPHSDS' between the two groups. Results: diffMPHSDS range was reduced by 32% in the individualized-dose group relative to the standard-dose group (p<0.003), whereas the mean 'diffMPHSDS' was equal: -0.42+/-0.46 and -0.48+/-0.67, respectively. Gain in HeightSDS 0-2 yrs was equal for the GH-deficient and the ISS groups; 1.31+/-0.47 and 1.36+/-0.47, respectively, when ISS was classified on the basis of maximum GH peak on the arginine-insulin tolerance test or 24h profile. Conclusion: Individualized GH doses during catch-up growth significantly reduces the proportion of unexpectedly good and poor responders around a predefined individual growth target and results in equal growth responses in children with GHD and ISS. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Endocrinology and Metabolism
volume
Nov 11
pages
483 - 490
publisher
The Endocrine Society
external identifiers
  • WOS:000263072700024
  • PMID:19001519
  • Scopus:59749099510
ISSN
1945-7197
DOI
10.1210/jc.2008-1503
language
English
LU publication?
yes
id
98da361f-9a7e-476b-be1b-b4ec261d3951 (old id 1271589)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19001519?dopt=Abstract
date added to LUP
2008-12-04 15:11:44
date last changed
2016-10-13 04:31:07
@misc{98da361f-9a7e-476b-be1b-b4ec261d3951,
  abstract     = {Context: Weight-based growth hormone (GH) dosing results in a wide variation in growth response in children with GH deficiency (GHD) or idiopathic short stature (ISS). Objective: The hypothesis tested was whether individualized GH doses, based on variation in GH responsiveness estimated by a prediction model, reduced variability in growth response around a set height target compared with a standardized weight-based dose. Setting: 153 short prepubertal children diagnosed with isolated GHD or ISS (n=43) and &gt;/=1 SDS below mid-parental height standard deviation score(MPHSDS) were included in this 2-year multicenter study. Intervention: The children were randomized to either a standard (43 microg/kg/d) or an individualized GH dose (17-100 microg/kg/d). Main outcome measure: Deviation of HeightSDS from individual MPHSDS (diffMPHSDS). The primary endpoint was difference in the range of 'diffMPHSDS' between the two groups. Results: diffMPHSDS range was reduced by 32% in the individualized-dose group relative to the standard-dose group (p&lt;0.003), whereas the mean 'diffMPHSDS' was equal: -0.42+/-0.46 and -0.48+/-0.67, respectively. Gain in HeightSDS 0-2 yrs was equal for the GH-deficient and the ISS groups; 1.31+/-0.47 and 1.36+/-0.47, respectively, when ISS was classified on the basis of maximum GH peak on the arginine-insulin tolerance test or 24h profile. Conclusion: Individualized GH doses during catch-up growth significantly reduces the proportion of unexpectedly good and poor responders around a predefined individual growth target and results in equal growth responses in children with GHD and ISS.},
  author       = {Kriström, Berit and Aronson, A Stefan and Dahlgren, Jovanna and Gustafsson, Jan and Halldin, Maria and Ivarsson, Sten and Nilsson, Nils-Eric and Svensson, Johan and Tuvemo, Torsten and Albertsson-Wikland, Kerstin},
  issn         = {1945-7197},
  language     = {eng},
  pages        = {483--490},
  publisher    = {ARRAY(0x99bc180)},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {Growth hormone (GH) dosing during catch-up growth guided by individual responsiveness decreases growth response variability in prepubertal children with GH deficiency or idiopathic short stature.},
  url          = {http://dx.doi.org/10.1210/jc.2008-1503},
  volume       = {Nov 11},
  year         = {2009},
}