The Effect of Combined Gonadal Suppression and Growth Hormone (GH) Treatment on Bone Maturation in Boys with Non-endocrine Short Stature (NESS)

We studied the effect of gonadal suppression and growth hormone (GH) combined treatment on bone maturation in children with non-endocrine short stature (NESS). Subjects were male children with NESS whose heights at the start of pubertal development had been less than 130 cm. Ten treated and eight untreated children were selected. Treated children were classified into two groups: Group 1 consisted of those with a bone age younger than 10.5 years at the start of treatment, and Group 2 of those with a bone age older than 10. 5 years at the start of treatment.In the untreated group, acceleration of bone maturation and decline of height SD score for bone age were not recognized even after secondary sex characteristics had appeared.In Group 1, bone maturation had not decelerated, and there had been no improvement in height SD score for bone age during the 3-year treatment. In Group 2, the δBA/δCA ratio was already suppressed from the first year of treatment, and the mean height SD score for bone age significantly increased during the three years.Although the effect of this combined treatment cannot be evaluated until final heights are achieved, these data suggest that gonadal suppression and GH-combined treatment is effective in increasing the final height and that the combined treatment should be started at a bone age later than 10.5 years in children with NESS.