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Improvement in Adult Height after Growth Hormone Treatment in Adolescents with Short Stature Born Small for Gestational Age: Results of a Randomized Controlled Study

2003; Oxford University Press; Volume: 88; Issue: 4 Linguagem: Inglês

10.1210/jc.2002-021123

1945-7197

Jean‐Claude Carel, Pierre Chatelain, P Rochiccioli, Jean‐Louis Chaussain,

Sexual Differentiation and Disorders

The efficacy of GH for increasing adult height (AH) in short adolescents born small for gestational age (SGA) is unclear, due to the lack of long-term controlled trials. A total of 168 short children born SGA (age, 10.5 yr for girls and 12.5 yr for boys) were randomly assigned to receive either 0.067 mg/kg·d GH until attainment of AH or no treatment. In this per-protocol analysis, 91 of 102 patients in the treated group and 33 of 47 patients in the control group were followed to AH. Mean height at inclusion was −3.2 sd score (SDS). Treatment duration was 2.7 ± 0.6 yr. AH was −2.7 ± 0.9 and −2.1 ± 1.0 SDS in the control and treated groups, respectively (P < 0.005). The groups differed by 0.6 SDS units (95% confidence interval, 0.2–0.9). Height gain was 0.5 ± 0.8 and 1.1 ± 0.9 SDS in the control and treated groups, respectively (P = 0.002). Multivariate analyses confirmed the independent effects of treatment (0.6 SDS) and treatment duration (0.4 SDS/yr). All potential biases would tend to decrease the estimate of the treatment effect. Treatment tolerance was excellent. We concluded that the potential for spontaneous catch-up in short adolescents born SGA is limited. GH treatment increases AH by at least 0.6 SDS in this population.