Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area.

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Besci Ö., Deveci Sevim R., Yüksek Acinikli K., Akın Kağızmanlı G., Ersoy S., Demir K., ...More

Journal of clinical research in pediatric endocrinology, vol.15, no.3, pp.268-275, 2023 (SCI-Expanded) identifier identifier


(rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on

anthropometric factors.

Methods: The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in

mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio

of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned

to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year

were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain

not at goal (NHAG).

Results: The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on

BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at

a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified

as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG

compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal

status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age

group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received

relatively lower doses (p=0.01).

Conclusion: Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth

responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.

Keywords: Body surface area, body weight, growth hormone, IGF-1, IGFBP-3, pharmacotherapy