Journal
GROWTH HORMONE & IGF RESEARCH
Volume 17, Issue 3, Pages 194-200Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ghir.2007.01.008
Keywords
bone; growth hormone treatment; insulin-like growth factor 1; intrauterine growth retardation; procollagen type 1 amino-terminal propeptide; short stature
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There is no way to predict early the growth response to growth hormone (GH) treatment in short children with intrauterine growth retardation (IUGR) or idiopathic short stature (ISS). Objective: To evaluate the capacity of the procollagen type 1 amino-terminal propeptide (P1NP), a new marker of bone formation, to help in this prediction. Patients and methods: Longitudinal study of 30 patients treated at 7.7 (range: 2.2-12.5) years for IUGR (n = 16) or ISS (n = 14) with GH (0.47 and 0.33 or 0.4 mg/kg/week respectively). P1NP and insulin-like growth factor I (IGF I) were measured before and after 3-6 months of GH treatment. Results: Before treatment, IUGR patients were younger and shorter than ISS patients, but their other characteristics were similar. IGF I Z-score (ZS) and P1NP concentrations were positively correlated in the whole population (Rho = 0.48; P = 0.01). After 3-6 months of treatment, both concentrations increased in IUGR and ISS (P < 0.01). They remained correlated only in ISS (Rho = 0.54; P < 0.05). P1NP before treatment was negatively correlated (Rho = -0.67, P = 0.015) with the growth rate (SD) during the first year of treatment in ISS but not in IUGR; IGF I ZS was not. The changes in P1NP for the whole population over 3-6 months, but not the changes in IGF I ZS, were positively correlated with the growth rate (Rho = 0.41, P = 0.03). Conclusions: Lower basal plasma P1NP concentrations predict better growth response to GH treatment during the first year in ISS children. Greater increases in its concentrations after 3-6 months of GH treatment may also predict a better growth response in both ISS and IUGR. (C) 2007 Elsevier Ltd. All rights reserved.
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