Background

There is no appropriate tool to predict recombinant human growth hormone (rhGH) response before therapy initiation in short-stature children in late puberty. The current study aimed to explore the associations between magnetic resonance imaging (MRI) stages of the knee growth plates and rhGH response in short-stature children in late puberty.

Methods

In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later.

Results

Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV_{1-3 mon} from 9.38 to 6.08 to 4.56 cm/year, GV_{4-6 mon} from 6.75 to 4.92 to 3.25 cm/year, and height gain from 4.03 to 2.75 to 1.95 cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01).

Conclusion

The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty.

Graphical abstract

中文翻译：

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膝盖磁共振成像：预测青春期后期身材矮小儿童重组人生长激素治疗反应的新方法

背景

在青春期后期身材矮小的儿童开始治疗之前，没有合适的工具来预测重组人生长激素 (rhGH) 的反应。目前的研究旨在探讨青春期后期身材矮小的儿童膝关节生长板的磁共振成像 (MRI) 分期与 rhGH 反应之间的关联。

方法

在这项前瞻性队列研究中，青春期后期身材矮小的儿童接受 rhGH 治疗并随访 6 个月。我们根据股骨远端或胫骨近端的生长板状态提出了一种新的膝关节MRI分期系统，并将参与者分为三组：未闭合生长板组、边缘闭合生长板组和近闭合生长板组。主要结果是身高增加和生长速度（GV），三个月后进行评估。

结果

共有 50 名参与者参加，其中包括 23 名男孩和 27 名女孩。 rhGH 治疗 6 个月后，三组的 GV 和身高增益连续下降，生长板融合程度增加，特别是按近端胫骨分组时（GV _{1-3 个月}从 9.38 到 6.08 到 4.56 厘米/年，GV _{4- 6 个月}从 6.75 到 4.92 到 3.25 厘米/年，身高增加从 4.03 到 2.75 到 1.95 厘米，所有P  < 0.001）。此外，生长板的 MRI 阶段独立地充当治疗后 GV 和身高增加的显着变量，特别是按近端胫骨分组时（所有P  < 0.01）。

结论

MRI 分期方法有望成为青春期后期身材矮小儿童开始治疗前预测 rhGH 反应的有效工具。

图形概要