Height at Start, First-Year Growth Response and Cause of Shortness at Birth Are Major Determinants of Adult Height Outcomes of Short Children Born Small for Gestational Age and Silver-Russell Syndrome Treated with Growth Hormone: Analysis of Data from KIGS

2010 ◽  
Vol 74 (4) ◽  
pp. 259-266 ◽  
Author(s):  
Michael B. Ranke ◽  
Anders Lindberg
Keyword(s):  
Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Response ◽  
Adult Height ◽  
First Year ◽  
Short Children ◽  
Hormone Analysis ◽  
Silver Russell Syndrome

Adult height in short children born small for gestational age treated with growth hormone

2020 ◽  
Vol 154 (8) ◽  
pp. 289-294
Author(s):  
Anunciación Beisti Ortego ◽  
Cristina Fuertes Rodrigo ◽  
Marta Ferrer Lozano ◽  
José Ignacio Labarta Aizpun ◽  
Antonio de Arriba Muñoz
Keyword(s):  
Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Adult Height ◽  
Short Children

scholarly journals New Horizons in Short Children Born Small for Gestational Age

2021 ◽  
Vol 9 ◽  
Author(s):  
Irène Netchine ◽  
Manouk van der Steen ◽  
Abel López-Bermejo ◽  
Ekaterina Koledova ◽  
Mohamad Maghnie
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Adult Height ◽  
Growth Spurt ◽  
Metabolic Abnormalities ◽  
Gh Treatment ◽  
Short Children ◽  
Increased Risk ◽  
Catch Up ◽  
Silver Russell Syndrome

Children born small for gestational age (SGA) comprise a heterogeneous group due to the varied nature of the cause. Approximately 85–90% have catch-up growth within the first 4 postnatal years, while the remainder remain short. In later life, children born SGA have an increased risk to develop metabolic abnormalities, including visceral adiposity, insulin resistance, and cardiovascular problems, and may have impaired pubertal onset and growth. The third “360° European Meeting on Growth and Endocrine Disorders” in Rome, Italy, in February 2018, funded by Merck KGaA, Germany, included a session that examined aspects of short children born SGA, with three presentations followed by a discussion period, on which this report is based. Children born SGA who remain short are eligible for GH treatment, which is an approved indication. GH treatment increases linear growth and can also improve some metabolic abnormalities. After stopping GH at near-adult height, metabolic parameters normalize, but pharmacological effects on lean body mass and fat mass are lost; continued monitoring of body composition and metabolic changes may be necessary. Guidelines have been published on diagnosis and management of children with Silver-Russell syndrome, who comprise a specific group of those born SGA; these children rarely have catch-up growth and GH treatment initiation as early as possible is recommended. Early and moderate pubertal growth spurt can occur in children born SGA, including those with Silver-Russell syndrome, and reduce adult height. Treatments that delay puberty, specifically metformin and gonadotropin releasing hormone analogs in combination with GH, have been proposed, but are used off-label, currently lack replication of data, and require further studies of efficacy and safety.

scholarly journals Growth response to an individualized versus fixed dose GH treatment in short children born small for gestational age: the OPTIMA study

2009 ◽  
Vol 160 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Heike Jung ◽  
Christof Land ◽  
Claudia Nicolay ◽  
Jean De Schepper ◽  
Werner F Blum ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Response ◽  
Safety Data ◽  
Fixed Dose ◽  
First Year ◽  
Promoting Effect ◽  
Gh Treatment ◽  
Growth Prediction ◽  
Short Children

ObjectiveInitial GH-induced catch up growth is highly variable in short children born small for gestational age (SGA) and mainly influenced by age at start of therapy and GH dose. This study compared the first year growth-promoting effect of an individually adjusted GH dose (IAD) versus a fixed high GH dose (FHD) in pre-pubertal children born SGA with severe short stature.DesignThis was a randomized, open-label, multi-center study.MethodsThe FHD group received 0.067 mg/kg per day GH throughout the 12-month study. The IAD group initially received 0.035 mg/kg per day GH; at 3 months the Cologne growth-prediction model for first year change in height SDS was applied; if predicted change was <0.75, GH was increased to 0.067 mg/kg per day for the remaining 9 months, otherwise the initial dose was continued.ResultsIn the IAD group, 38 out of the 80 patients required the higher GH dose from month 3. From an ANCOVA for non-inferiority, mean difference in change in height SDS between IAD and FHD groups was −0.24 (95% confidence interval (CI) −0.35: −0.12), the CI for height SDS being above the pre-defined non-inferiority margin of −0.5. GH dose reductions due to IGF-I SDS >0.5 and IGFBP-3 SDS <−0.5 were performed in 4/99 FHD patients, but none of the IAD group patients. Safety data were similar between groups.ConclusionWith a mean treatment group difference of 1 cm in 12-month growth response, although statistically significant, the IAD group was considered non-inferior compared with the FHD group. Early growth prediction can be used to tailor the dose to the individual patient's needs, resulting in lower overall GH dose.

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