Meta-analysis reveals greater growth responses to growth hormone therapy in growth hormone deficiency versus ISS and SGA, highlighting the benefit of early treatment.
Key Points
To directly compare baseline GH–IGF-1 axis profiles and clinical growth outcomes following recombinant human growth hormone (rhGH) therapy across children with growth hormone deficiency (GHD), idiopathic short stature (ISS), and small for gestational age (SGA).
Systematic search of PubMed/MEDLINE (2005–2024) identifying 47 studies comprising 18,642 children (9,214 GHD, 6,807 ISS, 2,621 SGA).
Assessed quality with Newcastle-Ottawa Scale, Cochrane RoB 2.0, and AMSTAR-2, calculating pooled mean differences (MD) and standardized mean differences (SMD) via random-effects models.
Baseline IGF-1 SDS was significantly lower in GHD (-2.9 ± 1.1) compared to ISS (-1.5 ± 1.2) and SGA (-1.3 ± 1.1; p<0.001).
Complete GHD demonstrated higher first-year height velocity than ISS (MD +0.80 cm/year; 95% CI 0.52–1.08) and SGA (MD +0.62 cm/year; 95% CI 0.28–0.96), with greater one-year ΔHeight SDS (vs ISS: SMD +0.24; 95% CI 0.17–0.31; vs SGA: SMD +0.19; 95% CI 0.09–0.29).
Younger age at treatment initiation and lower baseline IGF-1 SDS significantly predicted greater height gains and IGF-1 responses across cohorts.