TREATMENT WITH hGH HAS NO EFFECT ON ADULT HEIGHT IN HYPOPITUITARY CHILDREN

Abstract

Adult height of hypopituitary children following treatment with human pituitary growth hormone (hGH) is disappointingly low despite the fact that hGH administration before puberty results in accelerated statural growth without unduly accelerating bone maturation. Our study showed that the range of adult heights was similar for various types of hypopituitary growth retardation; this range did not undergo an appreciable upward shift after hGH treatment. Evaluation of hGH effectiveness for a well-defined type, that of multiple pituitary hormone deficiency following breech birth, disclosed that adult height was not dependent on the presence of hGH (14 patients with hGH averaged 162.9 cm (SEM 1.93), 10 patients without hGH 159.5 cm (SEM 3.49)). However, adult heights were reached at earlier ages (with hGH at 22.3 y (SEM .38), without hGH at 25.7 y (SEM .54)). The duration of the pubertal spurt in growth brought about by androgen treatment was reduced by hGH from 9.5 y (SEM .91) to 5.5 y (SEM .45). Skeletal maturation must have been faster during androgen with hGH than during androgen alone. More detailed follow-up studies are needed, particularly in view of the imminent rise in the number of patients that will undergo treatment with biosynthetic growth hormone. Earlier treatment with higher or more frequent doses may be required to improve effectiveness of GH on adult stature.

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