Linear growth and response to GH therapy in short children with normal vs low IGF1 level and normal BMI at presentation

Ashraf Soliman; Fawzia Alyafei; Nada Alaaraj; Noor Hamed; Shayma Mohamed

doi:10.1530/endoabs.99.EP395

We conducted a longitudinal study on 95 children presented to pediatric clinic with short stature. Children were classified to low IGF1 (IGF1SDS <-1) (n=25) and normal IGF1 (IGF1SDS >-1) (n=70) and treated with human GH (0.03: 0.05 mg/kg/day) for 2 years. Anthropometrics data (HtSDS, difference from mid-parental height SDS (MPHSD), BMISDS, bone age and IGF1 level were studied for 2 years.

Results: At presentation, the age, bone age, HtSDS and Growth velocity (GV) did not differ significantly among the 2 groups. The peak GH response to provocation was lower in the low IGF1. Children with low IGF1 had lower BMI vs those with normal IGF1. GH stimulation using clonidine showed that 10/25 (40%) of patients with low IGF1 have GH deficiency (Peak <7) while 23/70 (32.8%) of patients with normal IGF1 had low peak GH to provocation (not significant). The IGF1/GH peak ratio was significantly higher in the normal IGF1 group vs the low IGF1 group (higher response of IGF1 for their peak level of GH). After an average of 2 years of GH therapy (0.03 -0.05 mg/kg/day), The IGF1 SDS increased significantly in both groups with higher levels in the normal IGF1 group. the HtSDS increased significantly in both groups (P<0.01) however, the increment was significantly higher in the Low IGF1 group (+1.2 SD) vs the normal IGF1 group (+0.74 SD).

Anthropometric data and response to GH therapy in short children with low vs normal IGF1 level.
	Age 1	HTSD 1	BMISD 1	GV 1	Tanner stage 1	IGF1SD 1	Bone age 1	TSH 1	T4 1	Peak GH	IGF1/GH	MPHSD
IGFZ <-1	9.59	-2.3	-0.9	5.28	1.28	-1.7	8.08	3.25	15.9	4.24	16.1	-0.8
n=25	3.61	0.5	1.32	1.5	0.56	0.66	4.42	2.6	2.65	3.0	13.9	0.89

IGFZ>-1	9.97	-2.0	-0.26	5.6	1.64	0.25	8.98	2.5	15.9	6.6	52.74	-0.87
n=70	3.21	1.08	1.31	2.53	0.79	0.93	3.84	1.47	2.27	4.35	29.19	0.93


	Age 3	HTSD 3	BMISD 3	Tanner stage 3	IGF1SD 3	Bone age 3
IGFZ <-1	11.50	-1.03	-0.33	3.75	1.20	13.00
n=25	3.41	1.18	0.97	3.63	0.50	2.24

IGFZ>-1	11.55	-1.23	-0.32	3.00	2.46	10.40
n=70	3.34	0.96	1.28	0.00	0.49	4.18

Conclusion: Our data confirms good growth response to GH therapy and increment in IGF-1SDS in both low and normal IGF1 level with better growth response in the low IGF1 group.

Endocrine Abstracts

EP395