Growth response, psychosocial problems, and quality of life in children with growth hormone deficiency

Introduction
To establish an association between growth response to recombinant human growth hormone (rhGH) therapy and clinical and anthropometric parameters, d3-GHR polymorphism, psychosocial problems, and quality of life (QoL) in children with growth hormone deficiency (GHD).

Material and methods
The study included 46 prepubescent children with GHD and 80 healthy prepubescent children. To analyse growth response predictors for the rhGH therapy, a number of clinical and anthropometric parameters were selected. The polymorphism of exon 3 of the GHR gene was determined using multiple PCR amplification. Psychosocial functioning was assessed by the Strengths and Difficulties Questionnaire. The self-esteem was studied by the Dembo-Rubinstein method. The QoL was determined using the Peds QL4.0 questionnaire. Assessment of differences between the mean values of 2 independent variation series by the value of p was performed. The relationship between predictors and growth response was assessed using the Spearman coefficient of correlation.

Results
An association was found between height velocity (HV) (cm/yr; SDS) and chronological age, compliance, birth weight, height, height (SDS)-MPH (SDS), weight, peak GH response, rhGH dose, and d3-GHR/fl/l-GHR. The results suggest that the d3-GHR explains the better responsiveness to the rhGH therapy only for the first but not for the second year. The rhGH therapy leads to an improvement in the psychoemotional state, QoL, and self-esteem of children.

Conclusions
HV at the start of therapy, acceptable compliance, birth weight, growth at the start of therapy, height (SDS) – MPH (SDS), weight at the start of therapy, peak growth hormone response, and genotype d3-GHR are associated with the growth response to rhGH therapy. During the first and second years of therapy, a positive effect on the psychoemotional state, quality of life, and self-esteem of children with GHD was noted.