GH therapy can increase short-term growth and improve ( near ) final height .
Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature .
BACKGROUND Idiopathic short stature ( ISS ) refers to children who are very short compared with their peers for unknown or hereditary reasons .
Recombinant human growth hormone ( GH ) has been used to increase growth and final height in children with ISS .
OBJECTIVES To assess the effects of recombinant human GH on short-term growth and final height in children with ISS .
Growth parameters and predictors of growth in short children with and without growth hormone (GH) deficiency treated with human GH: a randomized controlled study.
Seventy-seven prepubertal short children with heights below the third centile for age and gender were divided into three groups according to their peak GH response to clonidine and insulin provocation .  Group ( I ) included 30 children with peak GH response < 7 micrograms/l , group ( II ) included 19 children , with GH peak response between 7 and 10 micrograms/l , and group ( III ) included 24 children with GH peak > 10 micrograms/l . Each group was divided into two subgroups , a and b. Subgroups (I)b , (II)a and (III)b were treated daily for 1 year with subcutaneous recombinant human growth hormone ( GH ) 15 U/m2/week , and group (I)a was treated with GH ( 30 U/m2/week ) . Before initiation of treatment , the chronological age , the height st and ard deviation score ( HtSDS ) , and the bone age delay did not differ among the study subgroups . The height growth velocity ( GV ) and insulin-like growth factor-I concentrations were significantly higher in group ( III ) , with normal GH response to provocation , compared to those for group ( I ) with GH deficiency . All the children had normal thyroid function and normal glucose tolerance . CT examination of the hypothalamic-pituitary area revealed a picture of empty sella ( either partial or complete ) in 35 per cent of the children in group ( I ) and 21 per cent of children in group ( II ) . After 1 year of GH therapy , the HtSDS , GV , and IGF-I concentrations increased significantly in the four subgroups treated with GH compared to their pretreatment values and to their controls . All the children in group ( I ) were responders ( increment in GV of 2 cm2/year above the pretreatment GV ) , of the nine subjects treated in group (II)a , one child was a non-responder and of the 12 children in group (III)a three children were non-responders . GV was non-significantly higher in group (I)a ( 30 U/m2/week ) v. group (I)b ( 15 U/m2/week ) . GV of children in groups (I)b , with abnormal GH response to provocation , was significantly higher than GV of children in group (III)a . Bone age advanced by less than 1 year in the treated groups ( 0.84 + /- 0.14 years ) v. the untreated groups ( 0.73 + /- 0.3 years ) . None of the children had impaired glucose tolerance or abnormal thyroid function after 1 year of GH therapy . In all the treated children , GV after 1 year of GH treatment was correlated significantly with the pretreatment GV ( r = -0.63 , P < 0.01 ) , peak GH response to provocation ( r = -0.59 , P < 0.01 ) , IGF-I concentration ( r = -0.54 , P < 0.01 ) , and positively with the GH dose ( r = 0.589 , P < 0.01 ) . In group ( III ) children , with normal GH reserve , GV correlated significantly with the pretreatment GV ( r = -0.48 , P < 0.01 ) and negatively with the GH peak response to provocation ( r = -0.25 , P < 0.05 ) . In conclusion , GH therapy improved GV of children growing along or parallel to the 3rd centile , irrespective of their GH response to provocation , without untoward effect on skeletal maturation , thyroid function or glucose tolerance
GH therapy can increase short-term growth and improve ( near ) final height .
Increases in height are such that treated individuals remain relatively short when compared with peers of normal stature .
BACKGROUND Idiopathic short stature ( ISS ) refers to children who are very short compared with their peers for unknown or hereditary reasons .
Recombinant human growth hormone ( GH ) has been used to increase growth and final height in children with ISS .
OBJECTIVES To assess the effects of recombinant human GH on short-term growth and final height in children with ISS .