Growth hormone treatment in young children with Down's syndrome: effects on growth and psychomotor development
a Department of
Genetics and Pathology, Unit of Clinical Genetics, Uppsala University
Children's Hospital, S-751 85 Uppsala, Sweden, b Department of Paediatrics, Uppsala University
Children's Hospital, c Department of Diagnostic Radiology, Uppsala
University Children's Hospital, d Paediatric
Endocrinology Unit, Karolinska Hospital, Stockholm, Sweden, e Centre for
Molecular Biotechnology, School of Life Science, Brisbane, Australia
Correspondence to: Dr Annerén. email: goran.anneren{at}ped.uas.lul.se
Accepted 20 November
1998
BACKGROUND
Learning
disability and short stature are cardinal signs of Down's syndrome.
Insulin-like growth factor I (IGF-I), regulated by growth hormone (GH)
from about 6 months of age, may be involved in brain development.
AIMSTo study long
term effects of GH on linear growth and psychomotor development in
young children with Down's syndrome.
Study
designFifteen children
with Down's syndrome were treated with GH for three years from the age
of 6 to 9 months (mean, 7.4). Linear growth, psychomotor development,
skeletal maturation, serum concentrations of IGF-I and its binding
proteins (BPs), and cerebrospinal fluid (CSF) concentrations of
IGF-II were studied.
RESULTSThe mean
height of the study group increased from 
1.8 to 0.8 SDS (Swedish
standard) during treatment, whereas that of a Down's syndrome control
group fell from 1.7 to 2.2 SDS. Growth velocity declined after
treatment stopped. Head growth did not accelerate during treatment. No
significant difference in mental or gross motor development was
found. The low concentrations of serum IGF-I and IGFBP-3 became normal
during GH treatment.
CONCLUSIONSGH
treatment results in normal growth velocity in Down's syndrome but
does not affect head circumference or mental or gross motor
development. Growth velocity declines after treatment stops.
© 1999 by Archives of Disease in Childhood
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