Growth Hormone (GH) Retesting and Final Adult Height in Childhood-Onset GH Deficiency (CO-GHD): Experiences from King Chulalongkorn Memorial Hospital, Thailand

Suttipong Wacharasindhu MRCPCH*, Suphab Aroonparkmongkol BSc*, Taninee Sahakitrungrueng MD*, Vichit Supornsilchai MD, PhD*

Affiliation : * Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, & Growth and Growth Monitoring Center, Pediatric Out-Patient Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Objective : Evaluate GH status in CO-GHD subjects after completion of linear growth, and report the auxological outcomes of rhGH treatment. Material and Method: Twenty-four CO-GHD subjects (14 with IGHD and 10 with MPHD), treated with rhGH for a period of 6.63.1 years were re-evaluated for their capacity of GH secretion by performing insulin tolerance test (ITT). Ht SDS at final height was compared with Ht SDS at the start of the treatment and MPH SDS.
Results : Thirty-eight percent (9 in 24) of CO-GHD subjects had normal GH secretion on retesting. All subjects were diagnosed as isolated GHD during childhood. In contrast, all MPHD subjects during childhood period had GH insufficiency on retesting. GH insufficient subjects had higher total cholesterol level than those with GH sufficiency (21451 vs. 17436 mg/mL, p = 0.03). rhGH treatment significantly increased Ht SDS of -2.01.1 at the start of the treatment to -0.61.3 at the end of the treatment (p<0.01) and -0.81.2 at GH retesting (p<0.01).
Conclusion : GH retesting is recommended in subjects with IGHD during the childhood period. However, rhGH treatment can enhance the final height in both GH sufficient and insufficient subjects on retesting.

Keywords : Growth hormone deficiency (GHD), childhood onset GHD (CO-GHD), isolated GHD (IGHD), multiple pituitary hormone deficiency (MPHD), GH retesting

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