Bone Maturation during Human Growth Hormone (GH) -treated GH Deficient Boys With and Without Gonadal Suppression Treatment

Bone age maturation was analyzed longitudinally by the TW2 RUS method in 45 GH-treated boys with idiopathic GH deficiency. Patients were divided into three groups: Group I consisted of 4 patients who underwent spontaneous puberty without gonadal suppression treatment (GST) and had a mean final height of 151.9 cm, Group II consisted of 17 patients with associated gonadotropin deficiency who had a mean final height of 165.3 cm, and Group III consisted of 24 patients who underwent spontaneous puberty and had a mean final height of 158.3 cm after being treated with combined gonadal suppression agents.The mean δbone age (BA) /δ chronological age (CA) ratios during GH treatment in the three groups were 1.70, 0.89, and 1.10, respectively. Final height correlated negatively with δBA/δCA ratio. The fact that bone maturation stopped at around 14 years in Group II without gonadal replacement suggests that sex steroids are necessary for further bone maturation. Gonadal suppression significantly delayed the rate of bone maturation, which resulted in a greater final height in Group III.

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