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Prediction of Adult Height in Growth-Hormone-Treated Children with Growth Hormone Deficiency

Dutch Growth Foundation (M.A.J.d.R., A.C.S.H.-K.), 3001 KB Rotterdam, The Netherlands; and Departments of Epidemiology and Biostatistics (M.A.J.d.R., T.S.) and Pediatrics (A.C.S.H.-K.), Division of Endocrinology, Sophia Children’s Hospital, Erasmus Medical Center, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: M. de Ridder, Dutch Growth Foundation, P.O. Box 23068, 3001 KB Rotterdam, The Netherlands. E-mail: m.deridder{at}erasmusmc.nl.

Context: Several studies have searched for factors that significantly influence adult height (AH) of children with GH deficiency (GHD) who have been treated with biosynthetic GH, but a prediction model for AH has not yet been presented.

Objective: Our objective was to develop models for prediction of AH, using information available at the start of GH treatment or after 1 yr of treatment.

Design and Setting: For this retrospective study, data were collected from the National Registry of Growth Hormone Treatment in Children, which contained data of Dutch children treated with GH.

Patients/Intervention: Patients included males born before 1985 and females born before 1987 with either diagnosis of GHD (syndromes, tumors, and other diseases were excluded) or a maximal GH response during provocation tests of less than 11 ng/ml, treated with biosynthetic GH for at least 1 yr. To be able to use the complete group of 342 children for the development of the models, multiple imputation was used for missing values.

Main Outcome Measure: We assessed AH SD scores (SDS).

Results: Each prediction model contained both target height SDS and current height SDS. The change in height SDS during the first year proved an important predictor for AH. In all models, addition of GH dose was not significant. The percent explained variance, after correction for overfitting, ranged from 37% (prepubertal children, prediction at start) to 60% (pubertal children, prediction after 1 yr).

Conclusion: The presented prediction models give accurate predictions of AH for children with GHD at start and after 1 yr of GH treatment. They are useful tools in the treatment of these children.

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