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The effectiveness of recombinant human growth hormone (rhGH) in increasing adult stature in non-GH deficient subjects has been the subject of inconclusive discussion for many years, primarily because of the paucity of data on the final height of rhGH-treated short subjects. In this issue of JCEM, two papers address this subject. Buchlis et al. (1) (see JCEM p. 1075) report the adult (or near adult) stature of 36 (6 females) normal short subjects [normal size at birth, height <2 sd scores at initial contact, growth rate <5 cm/yr, delayed skeletal maturation, and “normal” secretion of GH in response to provocative stimuli (peak GH ≥10 ng/mL by polyclonal radioimmunoassay)] treated with rhGH (0.3 mg/kg/week in 6–7 injections per week) for a mean of 41 months. They excluded patients with systemic disease, intrauterine growth retardation (IUGR), and chromosomal anomalies. The adult heights of the rhGH-treated subjects were compared with those of 58 (17 females) untreated subjects with similar characteristics evaluated before the widespread availability of rhGH. Final height was greater in the group of rhGH-treated subjects (−1.5 sd) than in the nontreated subjects (−2.1 sd, <0.001). However, the increase in achieved over predicted adult height of the 6 rhGH-treated females (+3.7 cm) was substantially more than that of the 30 males (+1.5 cm) and accounted for much of the net gain in stature attributed to the administration of rhGH. It was only in the rhGH-treated female subjects that the increase in mean final height seemed clinically significant (−1.3 vs. −2.5 sd in the untreated group). Because the achieved heights of the treated and untreated males were not significantly different than pretreatment predicted heights, it is difficult to discern a positive effect of rhGH on growth in male subjects.

Issue Section:
Editorial
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