Akademik Veri Yönetim Sistemi
ESPE 2022, Rome, İtalya, 15 - 17 Eylül 2022, ss.268-269
Objective: We aimed to evaluate the relation between the peak
growth hormone (GH) levels on provocative tests and response to
recombinant human GH (rhGH) therapy in patients with GH deficiency (GHD).
Methods: This was a cross-sectional, single-center, and retrospective study. A total of 518 patients who received rhGH therapy
under the age of 16 in the Endocrinology Clinic of Akdeniz
University Hospital between 1997 and 2021 were identified through the hospital’s digital database system. Patients who had
any genetic or chronic illness as well as using medication that may
affect growth and patients diagnosed with GH neurosecretory dysfunction, GH resistance, acquired GHD due to radiotherapy/chemotherapy/surgery were excluded from the study. Finally, 135
subjects who were diagnosed with GHD by using insulin tolerance
test and L-DOPA stimulation test and treated with rhGH for at
least two years were included in the study.
Results: The patients were classified as group I (Idiopathic
GHD, n=119) and group II (Multiple pituitary hormone deficiencies or having pathology on MRI, n=16). The idiopathic GHD
patients were classified into 3 subgroups according to the peak GH
values on the provocative tests (group Ia: peak GH < 3 μg/L, n=34;
group Ib: peak GH between 3 - 7 μg/L, n=71; group Ic: peak GH
between 7 - 10 μg/L, n=34). Height standard deviation score (SDS),
Δheight SDS, and height velocity (HV) SDS were all higher in
group Ia at the end of the 1st year of the rhGH therapy (p=0.040,
p=0.029, p=0.005). The height SDS was still significantly higher in
group Ia (p=0.033) while the HV SDS and Δheight SDS were similar between the groups at the end of the 2nd year of the therapy
(p=0.164 and p=0.522). 1st year HV SDS was significantly associated with midparenteral height SDS and peak GH value on provocative tests in multiple regression analyses (p=0.009, p=0.012).
Conclusion: It might be predicted that the lower the GH peak
on provocative tests, the better the response to the treatment. The
best HV is observed in the 1st year and the diagnosis should be
checked in the patients who had low first-year HV and had not
severely low GH peak on provocative tests.