Comparison of weight- vs body surface area-based growth hormone dosing for children: implications for response

Hughes, Ian P., Harris, Mark, Cotterill, Andrew, Ambler, Geoffrey, Cowell, Christopher T., Cutfield, Wayne S., Werther, George and Choong, Catherine S. (2013) Comparison of weight- vs body surface area-based growth hormone dosing for children: implications for response. Clinical Endocrinology, 80 3: 384-394. doi:10.1111/cen.12315

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Author Hughes, Ian P.
Harris, Mark
Cotterill, Andrew
Ambler, Geoffrey
Cowell, Christopher T.
Cutfield, Wayne S.
Werther, George
Choong, Catherine S.
Title Comparison of weight- vs body surface area-based growth hormone dosing for children: implications for response
Journal name Clinical Endocrinology   Check publisher's open access policy
ISSN 0300-0664
1365-2265
Publication date 2013-09-18
Sub-type Article (original research)
DOI 10.1111/cen.12315
Open Access Status
Volume 80
Issue 3
Start page 384
End page 394
Total pages 11
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2014
Language eng
Formatted abstract
Objective: To compare weight (per kg)- vs body surface area (BSA, per m2)-based growth hormone (GH) dosing formats in children and to derive a useful conversion formula between the two formats.

Patients and Design: Growth hormone doses (>33 000) from 1874 children were obtained from the national Australian database (OZGROW) and used to derive conversion formulae and to confirm the accuracy of a conversion formula based on a weight-only BSA estimate. A further 27 000 doses were used to test the accuracy of all formulae. The best conversion formula was used to compare weight- and surface area-based GH dosing, which included an analysis of first year response (ΔSDS height or growth velocity, GV).

Measurements: Growth hormone doses in mg/m 2/wk and mg/kg/wk, dose estimates, residuals, first year ΔSDS, first year GV.

Results: The formula, Dosekg = (4Wtkg + 7/Wtkg + 90) Dosem2/Wtkg; based on a weight-only BSA estimate, provides accurate dose conversion (mean residual, 0.005 mg/kg/week). A constant mg/m2/week dose expressed in terms of mg/kg/week declines quickly with increasing body weight to approximately 15 kg after which the decline continues although less dramatically. For Australian patients, despite an increase in mean per m2 dose with increased starting weight/age, the per kg dose decreased. This was associated with a greater decline in first year GV than estimated if a per kg dose had been maintained. Conclusions: Growth hormone doses can be accurately converted between formats. Surface area-based GH dosing is likely to result in a reduced height response as children become heavier when compared with weight-based GH dosing.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2014 Collection
School of Medicine Publications
 
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Created: Thu, 24 Apr 2014, 14:15:37 EST by Dominique Rossouw on behalf of Mater Research Institute-UQ