The presenting signs and treatment responses of the patients with growth hormone neurosecretory dysfunction and bioinactive growth hormone receiving growth hormone therapy in the department of pediatric endocrinology, Duzce University Medical School

Objectives: In this study, we aimed to investigate the response to growth hormone (GH) treatment and the factors that affect the short stature of the patients who applied to the Pediatric Endocrinology Clinic in Duzce University Faculty of Medicine with diagnosis of growth hormone neurosecretory dysfunction and bioinactive growth hormone. Material and Methods: Totally 65 patients, 24 patients diagnosed as growth hormone neurosecretory dysfunction and 41 patients diagnosed as bioinactive growth hormone, who admitted to Duzce University Medical School pediatric endocrinology clinic with short stature were investigated retrospectively. In the selection criteria, we accepted the patients who had not any chronic diseases 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.21 programme package and the level of p < 0.05 were considered significant statistically. Results: There were totally 65 patients consisted of 36 males, 29 females whose male/female ratio was 1,2. Patients received GH treatment for meanly 2,16 years. Height SDS showed a significant increase during the growth hormone therapy in both prepubertal and pubertal cases. We found a significant increase in growth velocity during the first year of GH treatment compared to pretreatment. There was no significant difference between the growth velocities during the first year of GH treatment of the patients with growth hormone neurosecretory dysfunction and bioinactive growth hormone. There was no correlation between the growth velocity during the first year of GH treatment and BMI. We found a significant increase in the median bone age after the GH treatment compared to the pretreatment bone age. The pubertal stage was increased after the treatment. Serum IGF-1 and IGFBP-3 levels were higher after the treatment. The mean maximum GH response to stimulation tests was 17,2±8 ng/ml in the patients with growth hormone neurosecretory dysfunction while it was 16±5,8 ng/ml in the patients with bioinactive growth hormone. The v mean nighttime GH response was 6,6±2,4 ng/ml in the patients with growth hormone neurosecretory dysfunction while it was 17,6±7,9 ng/ml in the patients with bioinactive growth hormone. After generation test mean serum IGF-1 level was 373,1±202,3 ng/ml and serum IGFBP-3 level was 4,6±1,1 ng/ml in the patients with bioinactive growth hormone. After generation test there was 149%±106,1 increase in mean serum IGF-1 level and 47%±41,1 increase in IGFBP-3 level. The mean serum IGF-1 and IGFBP-3 levels were significantly increased after the generation test. There was no correlation between the growth velocity during the first year of GH treatment and maximum GH response to stimulation tests and serum IGF-1 and IGFBP-3 levels increase after the generation test. Conclusion: The success of GH treatment in our patients was determined by some criteria. According to these criteria, after 1 year GH therapy the patients with height SDS increase of more than 0,3 was 67,7% (n=44) and 0,5 was 47,7% (n=31). The patients with a first-year height velocity increment of more than 3cm/yr was 62,7% (n=37). Besides, we found a significant increase statistically when we compared the pretreatment height SDS with 1st, 2nd and 3rd year height SDS values that showed a successful GH therapy. Key words: Bioinactive growth hormone, growth hormone neurosecretory dysfunction, growth hormone treatment, short stature.