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document
Adult height in short children born SGA treated with growth hormone and gonadotropin releasing hormone analog : results of a randomized , dose-response GH trial . CONTEXT GH treatment is effective in improving height in short children born small for gestational age ( SGA ) . GH is thought to have limited effect when started during adolescence . OBJECTIVE The aim of this study was to investigate GH treatment efficacy in short SGA children when treatment was started during adolescence ; to assess whether GH 2 mg/m ( 2 ) · d during puberty improves adult height ( AH ) compared with 1 mg/m ( 2 ) · d ; and to assess whether an additional 2-yr postponement of puberty by GnRH analog ( GnRHa ) improves AH in children who are short at the start of puberty ( < 140 cm ) , with a poor AH expectation . PATIENTS AND DESIGN In this longitudinal , randomized , dose-response GH trial , we included 121 short SGA children ( 60 boys ) at least 8 yr of age . We performed intention-to-treat analyses on all children and uncensored case analyses on 84 children who reached AH . Besides , we evaluated growth during 2 yr of combined GH/GnRHa and subsequent GH treatment until AH in a subgroup of 40 pubertal children with a height of less than 140 cm at the start . RESULTS Short SGA children started treatment at a median age of 11.2 yr , when 46 % had already started puberty . Median height increased from -2.9 at start to -1.7 sd score ( SDS ) at AH ( P < 0.001 ) . Treatment with GH 2 vs. 1 mg/m ( 2 ) · d during puberty resulted in significantly better AH ( P = 0.001 ) , also after correction for gender , age at start , height SDS at start , treatment years before puberty , and target height SDS . AH was similar in children who started puberty at less than 140 cm and received GH/GnRHa , compared with children who started puberty greater than 140 cm and received GH only ( P = 0.795 ) . CONCLUSION When started in adolescence , GH treatment significantly improves AH in short SGA children , particularly with GH 2 mg/m ( 2 ) · d during puberty . When SGA children are short at the start of puberty , they can benefit from combined GH/GnRHa treatment .
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Intervention_Pharmacological
growth hormone
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Intervention_Pharmacological
gonadotropin releasing hormone analog
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Intervention_Pharmacological
GH
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Intervention_Pharmacological
GH
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Intervention_Pharmacological
GH
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Intervention_Pharmacological
GH
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Outcome_Other
efficacy
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Participant_Age
Adult
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Participant_Age
children
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Participant_Condition
SGA
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Participant_Condition
short children born small for gestational age ( SGA )