小児研究の進歩
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概要

Growth Evaluation in Silver Russel Syndrome and Small Gestational Age Patients Exposed to GH Treatment: A Mathematical Approach

Bashair Alabbasi*

Objective: The study proposes a description and a mathematical model of growth of both Silver Russell Syndrome (SRS) and Small for Gestational Age (SGA) patients, with and without Growth Hormone (GH) treatment.

Design and methods: Thirteen patients with molecular diagnosis of SRS were compared with 13 sex-paired SGA subjects. For each patient, neonatal and follow up auxological data were collected. A predictive growth model based on the gompertzian function and optimization method, already tested and validated on a cohort of GH-deficient children, was used.

Results: Baselines anthropometric values do not significantly differ between the presented SRS and SGA populations. The applied mathematical model showed same natural growth hope for SGA and SRS subjects. In SRS patients under GH treatment a significant increase in growth hope seems to emerge from the prediction model, while an improvement in growth velocity was assessed in the counterpart of SGA subjects, which exhibit early response to the treatment.

Conclusion: The proposed mathematical prediction model indicates a benefit from GH treatment for both the SRS and SGA conditions; while SGA patients showed an earlier response, SRS patients have a longer term gain. These data suggest the need to anticipate the SRS diagnosis for starting with earlier therapy.