The response to growth hormone treatment i̇n pati̇ents wi̇th isolated growth hormone defi̇ci̇ency

Objectives: In this study, we aimed to investigate the response to growth hormone (GH) treatment and the factors that affecting in patients, who had complaints of short stature and had the diagnosis of isolated growth hormone deficiency, applied to the Pediatric Endocrinology Outpatient Clinic in Duzce University Faculty of Medicine Hospital. Material and Methods: 80 patients in accordance with our criteria of 111 patients were investigated retrospectively who admitted to our hospital' s pediatric endocrinology clinic, complaining of short stature and had been diagnosed as isolated GH deficiency. In selection criteria, we accepted that patients that should receive treatment for at least 1 year and had not a chronic disease affecting the growth and development, except hypothyroidism. Sex, birth weight, birth height, parental height, pretreatment ages, physical examination findings, laboratory findings, radiological assessments of the patients were examined and their affects in response to treatment were investigated. Statistical analysis were performed by the SPSS v.22 programe package and the level of p < 0.05 were considered as statistically significant. Results: Patients received the growth hormone treatment for at least one decimal year, maximum 6.6 decimal years and mean 2.7 decimal years. There were 40 males, 40 females and male / female ratio was found 1 for 80 patients. A significant positive correlation was observed for the target height and baseline BMI SDS when analysed against the first year growth. A significant negative correlation was found between pre-treatment height SDS, ∆BA(bone age), maximum stimulated GH and IGFBP-3 levels. While responses to the treatment couldn't be associated with gestational week, responses to the treatment of the patients with low birth weights were found to be better. While there was not a significant difference within the first year variational BMI SDS values, there were significant increments in second and third year BMI SDS values when they reached near-normal values. When we evaluated the effect of baseline IGFBP-3 SDS levels to the GH treatment responses, the patients with lower IGFBP-3 SDS levels showed a higher response to the treatment in the first three years. When we compared the maximum stimulated GH with the height SDS values for the first three years, the patients with higher levels of maximum stimulated GH showed a lower response to the treatment. Besides, although there was not a difference between groups for all examined parameters, treatment responses were found statistically significant. Bakker criterias were used for the evaluation of the success of theraphy. Response to the treatments of the patients were found 56,3%, when we handled the Bakker' s criteria of post treatment 1st year increase of height SDS >0,5. Conclusion: If patient, who were shorter and fatter and had lower BA, lower maximum stimulated GH, higher target height and lower pretreatment IGFBP-3 levels, grew more than others. GH treatment was successful according to both Bakker criterias and statisticall comparisons. Key words: Growth hormone treatment, childhood, isolated growth hormone deficiency, short stature.