Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height

Background/Objectives: Recombinant growth hormone (rhGH) treatment plays an important role in the transition phase in those subjects diagnosed as having persistent growth hormone deficiency (GHD). We aimed to identify the main predictors of persistent GHD in a large cohort of subjects with childhood...

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Main Authors: Flavia Urbano, Mariangela Chiarito, Luigi Antonio Moscogiuri, Crescenza Lattanzio, Rossella Vitale, Orazio Valerio Giannico, Gabriele Annesi, Clara Zecchino, Maria Felicia Faienza
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/3/324
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author Flavia Urbano
Mariangela Chiarito
Luigi Antonio Moscogiuri
Crescenza Lattanzio
Rossella Vitale
Orazio Valerio Giannico
Gabriele Annesi
Clara Zecchino
Maria Felicia Faienza
author_facet Flavia Urbano
Mariangela Chiarito
Luigi Antonio Moscogiuri
Crescenza Lattanzio
Rossella Vitale
Orazio Valerio Giannico
Gabriele Annesi
Clara Zecchino
Maria Felicia Faienza
author_sort Flavia Urbano
collection DOAJ
description Background/Objectives: Recombinant growth hormone (rhGH) treatment plays an important role in the transition phase in those subjects diagnosed as having persistent growth hormone deficiency (GHD). We aimed to identify the main predictors of persistent GHD in a large cohort of subjects with childhood-onset GHD who underwent retesting and their correlation with height gain and mid-parental height (MPH). Methods: Anthropometric data, such as growth rate; bone age (BA); IGF-1 SDS at the start, at 1 year, and at the end of rhGH therapy; GH peak at diagnosis and at retesting; brain Magnetic Resonance Imaging (MRI) at diagnosis; and height gain upon reaching final height (FH) and compared to MPH, were obtained from medical records of GHD patients. Results: Persistent GHD was detected in 37 out of 91 (40.7%) GHD subjects. In univariate analysis, persistent GHD was associated with growth rate at 1 year (<i>p</i> = 0.0117) and with the first test GH peak (<i>p</i> = 0.0290). In the regression analysis, persistent GHD was positively associated with growth rate at 1 year (<i>p</i> = 0.0294) and negatively with female gender (<i>p</i> = 0.0424). Height gain was positively associated with growth rate (<i>p</i> = 0.0010) and with age at onset (<i>p</i> = 0.0021), while an inverse association with BA at baseline (<i>p</i> = 0.0002) and IGF-1 SDS (<i>p</i> = 0.0321) was found. Conclusions: Our study confirmed that the most important predictor of persistent GHD is the growth rate in the first year of therapy. Furthermore, growth rate in the first year, female gender, and lower BA at diagnosis are predictors of rhGH efficacy both in terms of height gain and target height achievement.
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spelling doaj-art-28d4c640dbdf4558bf68e9f704bd8bcb2025-08-20T02:11:25ZengMDPI AGChildren2227-90672025-03-0112332410.3390/children12030324Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final HeightFlavia Urbano0Mariangela Chiarito1Luigi Antonio Moscogiuri2Crescenza Lattanzio3Rossella Vitale4Orazio Valerio Giannico5Gabriele Annesi6Clara Zecchino7Maria Felicia Faienza8Pediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyUnit of Statistics and Epidemiology, Local Health Authority of Taranto, 74121 Taranto, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Hospital “Giovanni XXIII”, 70126 Bari, ItalyPediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, ItalyBackground/Objectives: Recombinant growth hormone (rhGH) treatment plays an important role in the transition phase in those subjects diagnosed as having persistent growth hormone deficiency (GHD). We aimed to identify the main predictors of persistent GHD in a large cohort of subjects with childhood-onset GHD who underwent retesting and their correlation with height gain and mid-parental height (MPH). Methods: Anthropometric data, such as growth rate; bone age (BA); IGF-1 SDS at the start, at 1 year, and at the end of rhGH therapy; GH peak at diagnosis and at retesting; brain Magnetic Resonance Imaging (MRI) at diagnosis; and height gain upon reaching final height (FH) and compared to MPH, were obtained from medical records of GHD patients. Results: Persistent GHD was detected in 37 out of 91 (40.7%) GHD subjects. In univariate analysis, persistent GHD was associated with growth rate at 1 year (<i>p</i> = 0.0117) and with the first test GH peak (<i>p</i> = 0.0290). In the regression analysis, persistent GHD was positively associated with growth rate at 1 year (<i>p</i> = 0.0294) and negatively with female gender (<i>p</i> = 0.0424). Height gain was positively associated with growth rate (<i>p</i> = 0.0010) and with age at onset (<i>p</i> = 0.0021), while an inverse association with BA at baseline (<i>p</i> = 0.0002) and IGF-1 SDS (<i>p</i> = 0.0321) was found. Conclusions: Our study confirmed that the most important predictor of persistent GHD is the growth rate in the first year of therapy. Furthermore, growth rate in the first year, female gender, and lower BA at diagnosis are predictors of rhGH efficacy both in terms of height gain and target height achievement.https://www.mdpi.com/2227-9067/12/3/324predictive factorspersistent GHDfinal heighttransition phaseretesting
spellingShingle Flavia Urbano
Mariangela Chiarito
Luigi Antonio Moscogiuri
Crescenza Lattanzio
Rossella Vitale
Orazio Valerio Giannico
Gabriele Annesi
Clara Zecchino
Maria Felicia Faienza
Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
Children
predictive factors
persistent GHD
final height
transition phase
retesting
title Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
title_full Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
title_fullStr Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
title_full_unstemmed Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
title_short Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height
title_sort predictive factors of persistent growth hormone deficiency and impact on final height
topic predictive factors
persistent GHD
final height
transition phase
retesting
url https://www.mdpi.com/2227-9067/12/3/324
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