This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carel, J.-C. Articles by Chaussain, J.-L. Search for Related Content PubMed PubMed Citation Articles by Carel, J.-C. Articles by Chaussain, J.-L. Pubmed/NCBI databases Substance via MeSH

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

Department of Pediatric Endocrinology and Institut National de la Santé et de la Recherche Médicale U561 (J.-C.C., J.-L.C.), Groupe Hospitalier Cochin-Saint Vincent de Paul and Faculté Cochin-Université Paris V, 75014 Paris, France; Department of Pediatric Endocrinology (P.C.), Hôpital Debrousse, 69005 Lyon, France; and Department of Pediatric Endocrinology (P.R.), Hôpital des Enfants, 31059 Toulouse, France

Address all correspondence and requests for reprints to: Prof. Jean-Claude Carel, Pediatric Endocrinology and Institut National de la Santé et de la Recherche Médicale U561, Groupe Hospitalier Cochin-Saint Vincent de Paul, 82 av Denfert Rochereau, 75014 Paris, France. E-mail: carel{at}cochin.inserm.fr.

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.

This study was funded by Sanofi-Synthélabo (Paris, France).

Abbreviations: AH, Adult height; CI, confidence interval; SDS, SD score; SGA, small for gestational age.

This article has been cited by other articles:

				A. A. Romano, K. Dana, B. Bakker, D. A. Davis, J. J. Hunold, J. Jacobs, and B. Lippe Growth Response, Near-Adult Height, and Patterns of Growth and Puberty in Patients with Noonan Syndrome Treated with Growth Hormone J. Clin. Endocrinol. Metab., July 1, 2009; 94(7): 2338 - 2344. [Abstract] [Full Text] [PDF]

				A. Carrascosa, L. Audi, C. Esteban, M. Fernandez-Cancio, P. Andaluz, M. Gussinye, M. Clemente, D. Yeste, and M. A. Albisu Growth Hormone (GH) Dose, But Not Exon 3-Deleted/Full-Length GH Receptor Polymorphism Genotypes, Influences Growth Response to Two-Year GH Therapy in Short Small-for-Gestational-Age Children J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 147 - 153. [Abstract] [Full Text] [PDF]

				E. M. N. Bannink, J. van Doorn, P. G. H. Mulder, and A. C. S. Hokken-Koelega Free/Dissociable Insulin-Like Growth Factor (IGF)-I, Not Total IGF-I, Correlates with Growth Response during Growth Hormone Treatment in Children Born Small for Gestational Age J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 2992 - 3000. [Abstract] [Full Text] [PDF]

				J. Argente, R. Gracia, L. Ibanez, A. Oliver, E. Borrajo, A. Vela, J. P. Lopez-Siguero, M. L. Moreno, F. Rodriguez-Hierro, and on behalf of the Spanish SGA Working Group Improvement in Growth after Two Years of Growth Hormone Therapy in Very Young Children Born Small for Gestational Age and without Spontaneous Catch-Up Growth: Results of a Multicenter, Controlled, Randomized, Open Clinical Trial J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 3095 - 3101. [Abstract] [Full Text] [PDF]

				P. Saenger, P. Czernichow, I. Hughes, and E. O. Reiter Small for Gestational Age: Short Stature and Beyond Endocr. Rev., April 1, 2007; 28(2): 219 - 251. [Abstract] [Full Text] [PDF]

				A. Carrascosa, C. Esteban, R. Espadero, M. Fernandez-Cancio, P. Andaluz, M. Clemente, L. Audi, H. Wollmann, L. Fryklund, L. Parodi, et al. The d3/fl-Growth Hormone (GH) Receptor Polymorphism Does Not Influence the Effect of GH Treatment (66 {micro}g/kg per Day) or the Spontaneous Growth in Short Non-GH-Deficient Small-for-Gestational-Age Children: Results from a Two-Year Controlled Prospective Study in 170 Spanish Patients J. Clin. Endocrinol. Metab., September 1, 2006; 91(9): 3281 - 3286. [Abstract] [Full Text] [PDF]

				D. B. Allen Growth Hormone Therapy for Short Stature: Is the Benefit Worth the Burden? Pediatrics, July 1, 2006; 118(1): 343 - 348. [Full Text] [PDF]

				S. K. Varma Long-Term Growth Hormone Treatment of Idiopathic Short Stature AAP Grand Rounds, January 1, 2006; 15(1): 9 - 10. [Full Text] [PDF]

				M. Rosilio, J.-C. Carel, E. Ecosse, J.-L. Chaussainon, and on behalf of the 0908 Lilly Study Group Adult height of prepubertal short children born small for gestational age treated with GH Eur. J. Endocrinol., June 1, 2005; 152(6): 835 - 843. [Abstract] [Full Text] [PDF]

				J.-C. Carel Growth Hormone in Turner Syndrome: Twenty Years after, What Can We Tell our Patients? J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3793 - 3794. [Full Text] [PDF]

				N. Bridges New indications for growth hormone Arch. Dis. Child. Ed. Pract., June 1, 2005; 90(1): ep7 - ep9. [Full Text] [PDF]

				J.-C. Carel, E. Ecosse, I. Bastie-Sigeac, S. Cabrol, M. Tauber, J. Leger, M. Nicolino, R. Brauner, J.-L. Chaussain, and J. Coste Quality of Life Determinants in Young Women with Turner's Syndrome after Growth Hormone Treatment: Results of the StaTur Population-Based Cohort Study J. Clin. Endocrinol. Metab., April 1, 2005; 90(4): 1992 - 1997. [Abstract] [Full Text] [PDF]

				D. Brodsky and H. Christou Current Concepts in Intrauterine Growth Restriction J Intensive Care Med, November 1, 2004; 19(6): 307 - 319. [Abstract] [PDF]

				L B Johnston and M O Savage Should recombinant human growth hormone therapy be used in short small for gestational age children? Arch. Dis. Child., August 1, 2004; 89(8): 740 - 744. [Abstract] [Full Text] [PDF]

				S. R. Rose Growth Hormone Therapy Benefits Former SGA Infants AAP Grand Rounds, August 1, 2003; 10(2): 14 - 14. [Full Text] [PDF]