Near Adult Height and Body Mass Index Changes in Growth Hormone Treated Short Children with Noonan Syndrome: The Belgian Experience

Jean De Schepper, Muriel Thomas, Koen Huysentruyt, Marianne Becker, Emese Boros, Kristina Casteels, Olimpia Chivu, Kathleen De Waele, Hilde Dotremont, Philippe A Lysy, Guy Massa, Anne-Simone Parent, Anne Rochtus, Inge Gies

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: A variable near adult height (NAH) outcome after growth hormone (GH) therapy in Noonan syndrome (NS) patients with short stature has been reported. The main objective of this study was to evaluate NAH and body mass index (BMI) evolution in a large Belgian cohort of NS patients treated for short stature. The secondary objectives were to investigate whether sex, genotype, the presence of a thoracic deformity, and/or a heart anomaly might affect NAH and to validate the recently developed NAH prediction model by Ranke et al. Methods: Clinical and auxological data of GH treated short NS patients born before 2001 were extracted from the national Belgrow registry. NAH was available in 54 (35 male) genotyped NS using a gene panel of 9 genes, showing pathogenic variants in PTPN11 in 32 and in SOS1 in 5 patients, while in 17 patients gene panel analysis was inconclusive (no-mutation group). Results: After a median (P10; P90) duration of 5.4 (2.2; 10.3) years of GH therapy with a median dose of 0.05 mg/kg/day NS patients reached a median NAH of −1.7 (−3.1; −0.8) SDS. Median total height gain was 1.1 (0.1; 2.3) SDS. Sex, genotype, and the presence of a thoracic or cardiac malformation did not correlate with NAH or total height gain. Linear regression modelling revealed that height SDS at start (β = 0.90, p < 0.001), mid-parental height SDS (β = 0.27; p = 0.005), birth weight SDS (β = 0.15; p = 0.051), age at start (β = 0.07; p = 0.032) were independently associated with NAH SDS. Median BMI SDS increased significantly (p < 0.001) from −1.0 (−2.5; 0.0) at start to −0.2 (−1.5; 0.9) at NAH. The observed NAH in a subgroup of 44 patients with more than 3 years of GH treatment was not statistically different from the predicted NAH by the Noonan NAH prediction model of Ranke. Conclusion: Long-term GH therapy at a dose of 0.05 mg/kg/day in short NS patients is effective in improving adult height and BMI, irrespective of the genotype and presence or absence of cardiac and or thoracic anomalies.
Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalHormone Research in Paediatrics
DOIs
Publication statusPublished - 1 Mar 2024

Bibliographical note

Funding Information:
The study was funded by the Belgian and Luxembourg Society for Pediatric Endocrinology and Diabetology (BELSPEED). AR is supported by a post doc research fellowship funded by University Hospitals Leuven (KOOR-UZ Leuven).

Publisher Copyright:
© 2024 S. Karger AG, Basel.

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