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Final Height Following Growth HormoneTreatment of Idiopathic Growth Hormone
Deficiency in KIGS
Wayne S Cutfield, Anders Lindberg, Pierre Chatelain, David A Price, Kerstin Albertsson-Wikland, Patrick Wilton, and Michael B Ranke
on behalf of the KIGS International Board
KIGS 10 Year Book, 1999
W Cutfield - KIGS 10 Year Book, 1999
Variable Male patients Female patients
Total (n)– Caucasian (n)– Japanese (n)
223154 69
146115 31
Chronological age (years) 10.4 (5.1-13.4) 8.5* (4.1-12.1)
Birth weight (SDS) -0.6 (-1.8 to 0.8) -0.5 (-2.5 to 1.2)
MPH (SDS)– Caucasian (n)– Japanese (n)
-0.9 -2.1
(-2.6 to 0.9)(-3.4 to -0.9)
-0.7 -1.9
(-2.5 to 0.9)(-3.3 to -0.9)
Max GH peak (µg/L) 3.2 (0.7-8.4) 3.4 (0.6-8.0)
Height (SDS)– Caucasians– Japanese
-2.8 3.1
(-4.5 to -1.8)(-4.8 to -2.2)
-3.4* -3.3
(-5.0 to -2.1)(-4.4 to -2.8)
Multiple pituitary hormonedeficiencies (%)
52 46
Induced puberty (%) 33 27
Baseline characteristics of patients with idiopathic GHD prior to commencement of GH therapya
MPH, mid-parental height; SDS, standard deviation score* p<0.01aValues expressed as medians (10th - 90th percentiles)
W Cutfield - KIGS 10 Year Book, 1999
GH treatment regimens and auxological characteristics of patients with idiopathic GHD who have achieved final heighta
Variable Male patients Female patients
Duration of GH treatment(years)
8.3 (5.6-13.5) 8.0 (5.3-13.2)
GH dose (IU/kg/week) 0.48 (0.32-0.71) 0.53* (0.35-0.75)
GH injections per week 5.3 (3.2-6.9) 5.1 (3.0-6.9)
Chronological age (years) 18.9 (17.5-21.7) 17.1* (15.4-20.1)
Height (SDS)– Caucasians– Japanese
-0.9-2.2
(-2.6 to 0.6)(-3.5 to -1.2)
-1.2 -2.6*
(-2.8 to 0.4)(-4.3 to -2.0)
Final height – initial height(SDS)
1.8 (0.4-3.3) 1.6 (0.3-4.1)
Final height – MPH (SDS) -0.3 (-2.0 to 1.0) 0.7* (-2.7 to 0.5)
MPH, mid-parental height; SDS, standard deviation score* p<0.01aValues expressed as medians (10th - 90th percentiles)
W Cutfield - KIGS 10 Year Book, 1999
Final height achieved by male subjects with idiopathic growth hormone deficiency
(1/2)
130
135
140
145
150
155
160
165
170
175
180
185
190
195
10 12 14 16 18 20 22 24 26 28 30
Chronological age
Hei
ght (
cm)
Means ( ), +2 SD ( ),and -4 SD ( ).
Final height achieved by female subjects with idiopathic growthhormone deficiency
W Cutfield - KIGS 10 Year Book, 1999
(2/2)
110
115
120
125
130
135
140
145
150
155
160
165
170
175
180
185
Chronological age
10 12 14 16 18 20 22 24 26 28 30
Hei
ght (
cm)
Means ( ), +2 SD ( ),and -4 SD ( ).
W Cutfield - KIGS 10 Year Book, 1999
Comparison of patients with spontaneous onset of puberty andthose with induced puberty for whom auxological data were
available at onset of puberty (medians)Variable Male patients Female patients
Spontaneouspuberty(n=52)
Inducedpuberty(n=52)
Spontaneouspuberty(n=62)
Inducedpuberty(n=16)
At start of GH treatmentChronological age (years) 9.6 9.5 8.5 7.5Max GH peak (µg/L) 4.1 1.7* 4.2 1.6*MPH (SDS) -0.04 -0.6 -0.6 -0.3Height (SDS) -2.7 -3.1 -3.1 -3.5Height – MPH (SDS) -2.8 -2.6 -2.7 -3.3
At start of pubertyChronological age (years) 13.8 15.5* 12.9 14.2*Duration of GH therapy (years) 3.4 6.3* 3.8 6.4*Height (SDS) -1.7 -1.4 -1.7 -1.1Pubertal height – initial height(SDS)
1.1 1.7 1.5 2.0
Height – MPH (SDS) -1.2 -0.8 -0.9 -0.4
At final heightChronological age (years) 18.4 19.3 16.9 17.9Duration of puberty (years) 4.3 3.7 3.8 3.1Total pubertal growth (cm) 25.3 17.1 15.3 11.8Height (SDS) -0.9 -1.0 -1.8 -0.9Final height – pubertal height(SDS)
0.5 0.4 -0.2 0.1
Final height – initial height (SDS) 1.9 2.2 1.6 2.4Final height – MPH (SDS) -0.6 -0.2 -0.8 -0.2
MPH, mid-parental height; SDS, standard deviation score, * p<0.01
Variable rValue pValue
MPH (SDS) 0.62 <0.001
Total GH dose (IU) 0.49 <0.001
Height at start of GH (SDS) 0.45 <0.001
Injections (n/week) 0.37 <0.001
Birth weight (SDS) 0.31 <0.001
Weight at start of GH (SDS) 0.32 <0.001
Duration of GH treatment(years)
0.28 <0.001
Max GH peak (µg/L) -0.25 <0.001
Height velocity at 1 year (SDS) 0.20 <0.004
Chronological age (years) -0.19 <0.001
Mean GH dose (IU/kg/week) 0.15 NS
MPH, mid-parental height ; NS, not significant
W Cutfield - KIGS 10 Year Book, 1999
Relation of pretreatment and treatment variables to final height based on simple linear correlations
Patients(n)
Final height(SDS)
MPH(SDS)
Final height – MPH(SDS)
NCGS 1997– male– female
7249
-0.7-0.7
-0.3-0.2
-0.6-0.4
KIGS– male– female
223146
-1.4-2.0
-0.9-1.4
-0.3-0.7
Influence of mid-parental height on final height in the National Cooperative Growth Study (NCGS)a
and in KIGS subjects
W Cutfield - KIGS 10 Year Book, 1999
aNCGS data from Blethen et al (1997)
Difference in height SDS between idiopathic GH-deficient male subjects with induced or with spontaneous puberty at start of GH treatment, onset of puberty and final height
W Cutfield - KIGS 10 Year Book, 1999
Spontaneous InducedGH start
Spontaneous InducedPubertal onset
Spontaneous InducedFinal height
Hei
ght (
SDS)
Data are shown as 25th and 75 percentiles (box plots),medians (rules) and means (dots), with whiskers at the 10th and 90th percentiles
Difference in height SDS between idiopathic GH-deficient female subjects with induced or with spontaneous puberty at start of GH treatment, onset of puberty and final height
W Cutfield - KIGS 10 Year Book, 1999
Spontaneous InducedGH start
Spontaneous InducedPubertal onset
Spontaneous InducedFinal height
Hei
ght (
SDS)
Data are shown as 25th and 75 percentiles (box plots),medians (rules) and means (dots), with whiskers at the 10th and 90th percentiles