Evaluation of the Clinical Response to Treatment of Short Stature Using Growth Hormone Injection Versus Arginine Pills

Abstract

Background: Growth which is the process of physical maturation resulting in an increase in size of the body and various organ can considered as the final common pathway of many factors, including endocrine, environmental, nutritional, and genetic influences. A normal linear growth pattern is good evidence of overall health and can be considered as a bioassay for the well-being of the whole child.
Short stature is defined as subnormal height relative to other children of the same gender and age, taking family heights into consideration. it can be caused by numerous conditions could be a variation of normal like constitutional and familial short stature or due to endocrine disorders, skeletal dysplasias, lysosomal storage diseases or due to chronic diseases like chronic renal failure 
Growth hormone deficiency account for many cases of short stature, growth hormone (GH) is a 191–amino acid protein secreted by the pituitary in a pulsatile fashion, stimulated by hypothalamic GH-releasing hormone, and inhibited by somatotropin release–inhibiting factor or somatostatin. it stimulates growth, cell reproduction, and cell regeneration.
Recombinant human growth hormone injections which contain recombinant human growth hormone are used for treatment of short stature also newly developed pills which contain arginine that stimulates production of the growth hormone in the body are used for treatment of short stature.
Aim: To evaluate the efficacy of using arginine pills in the treatment of short stature. Patient and method: A cross-sectional comparative study done on patient with short stature attending the endocrine clinic at Tikrit Teaching Hospital during the period from the first of November 2022 to the last of October 2023.
For each child height in centimeters, and growth rate for height were measured. Height were  measured  using  stadiometer  in  which  standing  height  was  taken  with  the recommended standard measures like putting off a hat, bare foot, stand straight and looking forward. The previous measures for height for each child were taken from the follow up files of each child that is available at the endocrine clinic.
Results: The total number of cases were 63 cases. Male were 25 cases (39.7%) and females were 38 cases (60.3%) . Most of the cases were between 6-12 years 37 cases (58.7%), most of the cases were due to idiopathic short stature, 52 cases (82.54%).
In regard to treatment most of the cases treated with rhGH injections, 49 cases (77.78%), most of them treated for a period equal or less than one year, 52 cases (82.54%).
There is a non-significant relation between the mean increment in height per one month at different ages, genders, causes of short stature, and duration of therapy in regard to type of therapy with rhGH injection versus arginine pills.
Most of the cases have a normal growth rate for height while the relation between the growth rate for height and the age, gender of the child, causes of short stature, duration of therapy, and the type of therapy with rhGH injection versus arginine pills is not significant.
Conclusion: The study concludes that there was a non-significant relation between the mean increment in height per one month at different ages, genders, causes of short stature, and duration of therapy in regard to type of therapy with rhGH injection versus arginine pills.