The maturation of the long bones and short bones of the hand differs from the carpal bones. We aimed to determine role of GH. Bone age x-ray was performed in 12 children with GHD, 19 ISS children age 5.5 ±0.9 (m±sd) during 3 y of hGH treatment and 12 untreated ISS children. Individual bones were evaluated by a single blinded observer according to Greulich and Pyle, and are expressed as ‘years’ (y) of delay relative to chronological age.
In ISS, maturation was delayed by 1.87±0.3, 2.07±0.25 and 1.75±0.2 ‘y’ for RU, C and S bones, resp. In GHD, maturation was delayed by 3.1±0.4, 4.5±0.2 and 2.9±0.4 ‘y’ for RU, C and S bones, resp. In ISS over 3 y of GH treatment, RU advanced by a mean 3.5±0.4 ‘y’, as compared with untreated 3.3±0.7 ‘y’ (p<0.10), C advanced by a mean 4.2±0.7 ‘y’ on hGH and 3.3±0.6 ‘y’, in control (p<0.001), and S bones by a mean 3.5±0.9 ‘y’ on hGH and 3.15±0.7 ‘y’ in control (p<0.058). In GHD over 3 y of GH treatment, RU advanced by a mean 3.1±0.4 ‘y’, (p<0.10), C advanced by a mean 4.3±0.2 ‘y’ (p<0.001), and S bones 2.9±0.1(p<0.06).
These results suggest that GH strongly regulates and GHD interferes with bone maturation by inhibiting chondral osteogenesis and less so through delayed enchondroplasia, observed by RU and S maturation. These profiles help in the diagnosis of GHD.