Timing of Puberty, Pubertal Growth, and Adult Height in Short Children Born Small for Gestational Age Treated With Growth Hormone

Author:

Upners Emmie N12ORCID,Raket Lars Lau3,Petersen Jørgen H12,Thankamony Ajay4,Roche Edna5ORCID,Shaikh Guftar6,Kirk Jeremy7ORCID,Hoey Hilary5ORCID,Ivarsson Sten-A8,Söder Olle9,Juul Anders1210ORCID,Jensen Rikke Beck12ORCID

Affiliation:

1. Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet , Copenhagen , Denmark

2. International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital—Rigshospitalet , Copenhagen , Denmark

3. Department of Clinical Sciences, Lund University , Lund , Sweden

4. Department of Pediatrics, University of Cambridge , Cambridge Biomedical Campus, Cambridge CB2 0QQ , UK

5. Department of Pediatrics, CHI at Tallaght University Hospital, Trinity College Dublin, The University of Dublin , Dublin 24 , Ireland

6. Department of Endocrinology, Royal Hospital for Children , Glasgow G51 4TF , UK

7. Department of Endocrinology, Birmingham Children’s Hospital , Birmingham B4 6NH , UK

8. Department of Clinical Sciences, Endocrine and Diabetes Unit, University of Lund , 22100 Lund , Sweden

9. Pediatric Endocrinology Unit, Department of Women’s and Children’s Health, Karolinska Institute , 17177 Stockholm , Sweden

10. Department of Clinical Medicine, University of Copenhagen , Denmark

Abstract

Abstract Context Growth hormone (GH) is used to treat short children born small for gestational age (SGA); however, the effects of treatment on pubertal timing and adult height are rarely studied. Objective To evaluate adult height and peak height velocity in short GH-treated SGA children. Methods Prospective longitudinal multicenter study. Participants were short children born SGA treated with GH therapy (n = 102). Adult height was reported in 47 children. A reference cohort of Danish children was used. Main outcome measures were adult height, peak height velocity, age at peak height, and pubertal onset. Pubertal onset was converted to SD score (SDS) using Danish reference data. Results Gain in height SDS from start of treatment until adult height was significant in both girls (0.94 [0.75; 1.53] SDS, P = .02) and boys (1.57 [1.13; 2.15] SDS, P < .001). No difference in adult height between GH dosage groups was observed. Peak height velocity was lower than a reference cohort for girls (6.5 [5.9; 7.6] cm/year vs 7.9 [7.4; 8.5] cm/year, P < .001) and boys (9.5 [8.4; 10.7] cm/year vs 10.1 [9.7; 10.7] cm/year, P = .002), but no difference in age at peak height velocity was seen. Puberty onset was earlier in SGA boys than a reference cohort (1.06 [–0.03; 1.96] SDS vs 0 SDS, P = .002) but not in girls (0.38 [–0.19; 1.05] SDS vs 0 SDS, P = .18). Conclusion GH treatment improved adult height. Peak height velocity was reduced, but age at peak height velocity did not differ compared with the reference cohort. SGA boys had an earlier pubertal onset compared with the reference cohort.

Funder

Novo Nordisk

Candy Foundation

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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