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 Maghnie, M. Articles by Loche, S. Search for Related Content PubMed PubMed Citation Articles by Maghnie, M. Articles by Loche, S. Related Collections Neuroendocrinology and Pituitary Pediatric Endocrinology

Adult Height in Patients with Permanent Growth Hormone Deficiency with and without Multiple Pituitary Hormone Deficiencies

Departments of Pediatrics, (M.M., L.A., N.d.I., R.L.), University of Genova, Instituto di Ricovero e Cura a Carattere Scientifico Giannina Gaslini, 16147 Genova, Italy; Department of Pediatrics (M.C., M.G.U.), Bambino Gesù, 00165 Rome, Italy; Department of Pediatrics (G.P., G.C.), Instituto di Ricovero e Cura a Carattere Scientifico, Fondazione Centro San Raffaele, Università Vita-Salute, 20132 Milan, Italy; Department of Pediatrics (L.G.), University of Parma, 43100 Parma, Italy; Biometry-Scientific Direction (C.T.), Instituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, 27100 Pavia, Italy; and Ospedale Regionale per le Microcitemie (S.P., S.L.), 09121 Cagliari, Italy

Address all correspondence and requests for reprints to: Mohamad Maghnie, M.D., Ph.D., Associate Professor of Pediatrics, Department of Pediatrics, Instituto di Ricovero e Cura a Carattere Scientifico, G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147 Genova, Italy. E-mail: mohamadmaghnie{at}ospedale-gaslini.ge.it.

Context: It has been reported that patients with multiple pituitary hormone deficiencies (MPHDs) achieve a greater final height, compared with patients with isolated GH deficiency (IGHD). However, the outcome of patients with permanent GH deficiency (GHD) has not yet been reported.

Objectives: The objectives of the study were to evaluate and compare adult height data and the effect of spontaneous or induced puberty after long-term treatment with GH in young adults with either permanent IGHD or MPHD.

Design and Setting: This was a retrospective multicenter study conducted in university research hospitals and a tertiary referral endocrine unit.

Patients and Methods: Thirty-nine patients with IGHD (26 males, 13 females) and 49 with MPHD (31 males, 18 females), diagnosed at a median age of 7.7 and 6.9 yr, respectively, were reevaluated for GH secretion after adult height achievement (median age 17.6 and 19.8 yr). The diagnosis of permanent GHD was based on peak GH levels less than 3 µg/liter after an insulin tolerance test or peak GH levels less than 5 µg/liter after two different tests. Fifteen subjects had idiopathic GHD and seventy-three had magnetic resonance imaging evidence of congenital hypothalamic-pituitary abnormalities. Height SD score (SDS) was analyzed at diagnosis, the onset of puberty (either spontaneous or induced), and the time of GH withdrawal.

Results: The subjects with IGHD entered puberty at a median age of 12.6 yr (females) and 13.4 yr (males). Puberty was induced at a median age of 13.5 and 14.0 yr, respectively, in males and females with MPHD. Median height SDS at the beginning of puberty was similar in the IGHD and MPHD subjects. Total pubertal height gain was similar between patients with IGHD or MPHD. Median adult height was also not significantly different between IGHD and MPHD patients (males, 168.5 vs. 170.3 cm; females, 160.0 vs. 157.3 cm). The adult height SDS of the IGHD subjects was positively correlated with height at the time of diagnosis and with total pubertal height gain. Conversely, the adult height SDS of the MPHD subjects was positively correlated with both the duration of GH treatment and height SDS at the time of GHD diagnosis.

Conclusions: Adult height in patients with permanent IGHD and spontaneous puberty is similar to adult height in patients with MPHD and induced puberty.

This article has been cited by other articles:

				T Edouard, S Grunenwald, I Gennero, J P Salles, and M Tauber Prevalence of IGF1 deficiency in prepubertal children with isolated short stature Eur. J. Endocrinol., July 1, 2009; 161(1): 43 - 50. [Abstract] [Full Text] [PDF]

				S. Zucchini, P. Pirazzoli, F. Baronio, M. Gennari, M. O. Bal, A. Balsamo, S. Gualandi, and A. Cicognani Effect on Adult Height of Pubertal Growth Hormone Retesting and Withdrawal of Therapy in Patients with Previously Diagnosed Growth Hormone Deficiency J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4271 - 4276. [Abstract] [Full Text] [PDF]