The effect of growth hormone treatment on growth rate of growth retardation in patients with growth hormone deficiency, small for gestational age and idiopathic short stature

Objective: The aim of this study is to investigate the treatment efficacy by comparing anthropometric measurement values, laboratory results and radiological imaging findings at the beginning and duration of treatment with growth hormone of patients partial growth hormone deficiency (PGHD), complete growth hormone deficiency (CGHD), small for gestational age (SGA) and idiopathic short stature (İSS) followed by growth retardation. Material and Method: In this study; the 3 year follow-ups of 202 patients who were admitted to the İnonu University Faculty of Medicine, Department of Pediatrics, Department of Pediatric Endocrinology and Diabetes Department between January 2002 and February 2019 and who were treated for growth hormone were reviewed retrospectively. Application complaints from the polyclinic file information of the cases included in the study, age of onset of the complaints, age of application, CV and family history, anthropometric measurement values (height SDS, height velocity, PAH, Age/ Bone Age, BMI SDS), mother and father height, target height, target height SDS, physical examination findings, puberty stages, laboratory and radiological imaging findings were recorded. Regular follow-up findings of the patients were recorded at three-month intervals. Patients were grouped according to their diagnosis as PGHD, CGHD, SGA and İSS. Height SDS, Δ height SDS, Δ (height SDS-target height SDS), height velocity, PAH, Age/Bone Age, BMI SDS, IGF-1 SDS, IGFBP-3 SDS, BH dose values were compared at the time of diagnosis and treatment of the groups within themselves groups. The same comparison was made between groups. Results: İn patients treated with GH were detected 69 (34.2%) of the PGHD, 43 (21.3%) of CGHD, 53 (26.2%) of SGA and 37 (18.3%) of ISS. The cases were administered low dose GH average 0.22 mg/kg/week (31.03 mcg/kg/day). İn patients diagnosed with PGHE, CGHD and SGA in the 3rd year of the treatment of GH, the height velocity, height SDS and PAH values increased significantly (p<0.05). Especially in cases with GHD, this increase was found to be significant from the second year onwards. It was observed that starting treatment in prepubertal or pubertal period did not change the final lenght. In the ISS group with low dose BH treatment, although a statistically insignificant increase was observed in the height growth rate and height SDS value with respect to the start of treatment, showed a significant increase in the predicted final height values. It was determined that the BMI SDS value in the patients with GHD was within the normal range before treatment, and with growth hormone therapy this value did not change in the CGHD group and it was decreased in the PGHD group with the treatment of GH. Although the annual growth rate was higher in all groups in the prepubertal period, it was observed that starting treatment in the prepubertal or pubertal period did not change the final length. No serious and life-threatening side effects were observed during the treatment. Conclusion: It was determined that BH treatment is an effective and reliable treatment method for improving short stature in patients with PGHD, CGHD and SGA. It was determined that the diagnosis of the patients at an early age provides longer treatment opportunities and increases the height gain. Keywords: Growth hormone deficiency, height SDS, height velocity, predict adult height, body mass index, growth hormone