Association of baseline body mass index with growth responses to growth hormone therapy in children with growth hormone deficiency
Sukdong Yoo, Ha Young Jo, Jeong Eun Lee, Jung Hyun Lee, Sejin Kim, Jung Eun Moon, Chong Kun CheonAbstract
Objectives
This study aimed to evaluate the association of baseline body mass index (BMI) status with long-term growth and metabolic outcomes during growth hormone (GH) therapy in children with GH deficiency (GHD).
Methods
From the LG Growth Study, we analyzed 155 children with GHD receiving GH for ≥36 months after age-based propensity score matching (78 elevated-BMI; 77 normal-BMI). Multivariable regression assessed baseline BMI-standard deviation score (SDS) in relation to 36-month changes in height SDS by bone age (BA). Group comparisons assessed longitudinal growth and metabolic outcomes; separate matched obesity and overweight analyses were exploratory.
Results
Baseline height SDS by chronological age (CA) did not differ significantly between groups (−2.33 ± 0.58 vs. −2.45 ± 0.65; p=0.1464), whereas height SDS by BA was higher in the elevated-BMI group (0.00 ± 1.68 vs. −0.73 ± 1.28; p=0.0131). Height velocity trajectories were similar (group-by-time p=0.9585). Height SDS by CA improved comparably between groups, whereas ΔHeight SDS by BA differed significantly at 12 months (p=0.0387) and 36 months (p=0.001). Higher baseline BMI-SDS was associated with a lower 36-month change in height SDS by BA in the adjusted model (β=−0.3525; p=0.0216). BMI-SDS decreased in the elevated-BMI group during the first year (p<0.0001), and total cholesterol decreased in both groups.
Conclusions
Higher baseline BMI-SDS was associated with a lower 36-month change in height SDS by BA during GH therapy, while CA-based height gains did not differ significantly between groups.