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657 The Role of Growth Hormone in Bone Maturation: Evaluation by Hand X-Ray
  1. L Even1,
  2. Z Hochberg2
  1. 1Pediatrics, Bar Ilan Western Gallile Hospital, Naharia
  2. 2Technion, Haifa, Israel


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.

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