The Relationships of Pretreatment IGF-I SDS, Delay in Bone Age and Response to Recombinant Human Growth Hormone(rhGH) Therapy in Children with Growth Hormone Deficiency |
Seon-Young You, Ki-Joong Kim, Jeh-Hoon Shin, Jin-Nyoung Park, Hee-Jeong Ahn, Yong-Joo Kim |
Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea |
성장호르몬 결핍증 환아에서 치료전 IGF-I SDS 및 골연령 지연과 성장호르몬 치료에 대한 반응과의 상관관계 |
유선영, 김기중, 신재훈, 박진녕, 안희정, 김용주 |
한양대학교 의과대학 소아과학교실 |
Correspondence:
Jeh-Hoon Shin, Email: 1 |
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Abstract |
Purpose : To assess whether pretreatment IGF-I SDS and pretreatmental bone age are useful
indicators in the response of rhGH therapy in children with GH deficiency(GHD), the relationship
between pretreatment IGF-I SDS, delay in bone age and the growth response during the first year
of rhGH treatment was analyzed.
Methods : This study included 12 children with GHD. We measured IGF-I levels by RIA after
acid-ethanol extraction at pretreatment and then calculated IGF-I SDS as follow : SDS =(IGF-Imean
IGF-I for normal subjects of the same age and sex)/SD of IGF-I for normal subjects of the
same age and sex. GH levels were measured by immunoradiometric assay. All patients were
treated with rhGH, 0.1IU/kg daily, 6 times a week for 1 year.
Results : Twelve patients (6 males and 6 females), age distribution from 4 to 16 years, were
studed. The data is reported as the mean±SD. Height SDS for chronologic age of the group as a
whole as -3.6±1.0 and bone age was 8.2±3.4 years. Pretreatment height velocity (HV) was
4.0±1.7cm/yr and the HV during each 3 months of therapy were 10.1±4.5cm/yr, 9.6±4.5cm/yr,
8.5±4.3cm/yr and 7.8±1.3cm/yr, respectively and therefore the HV during the first year of rhGH
therapy increased to 9.3±2.9cm/yr (P =0.002). Pretreatmental IGF-I SDS was -2.2±0.9 (-0.4~-3.6).
A significant negative correlation between pretreatmental IGF-I SDS and incremental height gain
was obtained (r=-0.40, P < 0.05). The height velocity of the group whose pretreatmental IGF-I SDS
was below -2 (n=8) as a whole increased significantly from 3.5±1.8cm/yr to 10.3±2.9cm/yr
(P =0.001). Pretreatmental bone age delay was 3.1±1.9(0.5-7.8) years. The height velocity of the
group whose pretreatmental bone age delay above 2 years(n=9) increased significantly from
4.1±1.1cm/yr to 9.7±2.9cm/yr (P =0.001). Conclusion : The height velocity of GH deficient children whose pretreatmental IGF-I SDS below
-2 or pretreatmental bone age delay above 2 years increased significantly after rhGH therapy. It
suggests that the pretreatmental IGF-I SDS and pretreatmental bone age may be significant
indicatiors in the response of GH therapy in children with GHD. |
Key Words:
Growth hormone deficiency, IGF-I, Bone age, Prediction, Growth hormone therapy |
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