Growth response of syndromic versus non-syndromic children born small for  gestational age (SGA) to growth hormone therapy: a Belgian study.

Becker, Marianne; Thomas, Muriel; Brachet, Cécile; Heinrichs, Claudine; Dotremont, Hilde; De Schepper, Jean; Lysy, Philippe; Beckers, Dominique; BESPEED, group

doi:10.3389/fendo.2023.1112938

Article (Scientific journals)

Growth response of syndromic versus non-syndromic children born small for gestational age (SGA) to growth hormone therapy: a Belgian study.

Becker, Marianne; Thomas, Muriel; Brachet, Cécile et al.

2023 • In Frontiers in Endocrinology, 14, p. 1112938

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/311585

DOI
10.3389/fendo.2023.1112938

PubMed
37334282

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Keywords :

Growth Hormone; Human Growth Hormone; Recombinant Proteins; Infant, Newborn; Female; Adult; Humans; Child; Human Growth Hormone/therapeutic use; Belgium/epidemiology; Gestational Age; Fetal Growth Retardation/drug therapy; Infant, Newborn, Diseases/drug therapy; adult height; children; growth; growth hormone; short for gestational age; short stature; syndromic

Abstract :

[en] INTRODUCTION: A substantial proportion of SGA patients present with a syndrome underlying their growth restriction. Most SGA cohorts comprise both syndromic and non-syndromic patients impeding delineation of the recombinant human growth hormone (rhGH) response. We present a detailed characterization of a SGA cohort and analyze rhGH response based on adult height (AH). METHODS: Clinical and auxological data of SGA patients treated with rhGH, who had reached AH, were retrieved from BELGROW, a national database of all rhGH treated patients held by BESPEED (BElgian Society for PEdiatric Endocrinology and Diabetology). SGA patients were categorized in syndromic or non-syndromic patients. RESULTS: 272 patients were included, 42 classified as syndromic (most frequent diagnosis (n=6): fetal alcohol syndrome and Silver-Russell syndrome). Compared with non-syndromic patients, syndromic were younger [years (median (P10/P90)] 7.43 (4.3/12.37) vs 10.21 (5.43/14.03), p=0.0005), shorter (height SDS -3.39 (-5.6/-2.62) vs -3.07 (-3.74/-2.62), p=0.0253) and thinner (BMI -1.70 (-3.67/0.04) vs -1.14 (-2.47/0.27) SDS, p=0.0054) at start of rhGH treatment. First year rhGH response was comparable (delta height SDS +0.54 (0.24/0.94) vs +0.56 (0.26/0.92), p=0.94). Growth pattern differed with syndromic patients having a higher prepubertal (SDS +1.26 vs +0.83, p=0.0048), but a lower pubertal height gain compared to the non-syndromic group (SDS -0.28 vs 0.44, p=0.0001). Mean rhGH dose was higher in syndromic SGA patients (mg/kg body weight/day 0.047 (0.039/0.064) vs 0.043 (0.035/0.056), p=0.0042). AH SDS was lower in syndromic SGA patients (-2.59 (-4.99/-1.57) vs -2.32 (-3.3/-1.2), p=0.0107). The majority in both groups remained short (<-2 SDS: syndromic 71%, non-syndromic 63%). Total height gain was comparable in both groups (delta height SDS +0.76 (-0.70/1.48) vs +0.86 (-0.12/1.86), p=0.41). CONCLUSIONS: Compared to non-syndromic SGA patients, syndromic SGA patients were shorter when starting rhGH therapy, started rhGH therapy earlier, and received a higher dose of rhGH. At AH, syndromic SGA patients were shorter than non-syndromic ones, but their height gain under rhGH therapy was comparable.

Disciplines :

Endocrinology, metabolism & nutrition
Pediatrics

Author, co-author :

Becker, Marianne; Department of Pediatric Endocrinology and Diabetology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.

Thomas, Muriel; The BElgian Society for PEdiatric Endocrinology and Diabetology (BESPEED), Brussels, Belgium.

Brachet, Cécile; Pediatric Endocrinology Unit, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université libre de Bruxelles (ULB), Brussels, Belgium.

Heinrichs, Claudine; Pediatric Endocrinology Unit, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université libre de Bruxelles (ULB), Brussels, Belgium.

Dotremont, Hilde; Department of Pediatric Endocrinology and Diabetology, University Hospital Antwerp, Edegem, Belgium.

De Schepper, Jean; University Hospital of Brussels, Brussels, Belgium.

Lysy, Philippe; Department of Pediatric Endocrinology and Diabetology, UCLouvain, Brussels, Belgium.

Beckers, Dominique; Department of Pediatric Endocrinology and Diabetology, UCLouvain, CHU UCL Namur, Yvoir, Belgium.

BESPEED, group

Other collaborator :

Rochtus, Anne

Parent, Anne-Simone ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pédiatrie

Klink, Daniel

Massa, Guy

Logghe, Karl

De Waele, Kathleen

Casteels, Kristina

Cools, Martine

Staels, Willem

Language :

English

Title :

Growth response of syndromic versus non-syndromic children born small for gestational age (SGA) to growth hormone therapy: a Belgian study.

Publication date :

June 2023

Journal title :

Frontiers in Endocrinology

eISSN :

1664-2392

Publisher :

Frontiers Media S.A., Ch

Volume :

Pages :

1112938

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 19 January 2024

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