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Growth hormone: panacea or punishment for short stature?

BMJ 1997; 315 doi: (Published 20 September 1997) Cite this as: BMJ 1997;315:692

Learning to live with being short is more important for short normal children

  1. C G D Brook, Professora (
  1. a London Centre for Paediatric Endocrinology, Great Ormond Street and the Middlesex Hospitals, London WC1N 3JH

After the nutrition dependent phase of fetal and infant growth has ended (towards the latter part of the first year of life) growth hormone secretion becomes the predominant controller of the rate of human growth.1 Almost any child given growth hormone in sufficient doses will grow more quickly, and dose-response curves for human growth hormone treatment have been with us for some years.2

Although much has been written about the predictors of response to treatment, only final height really matters. The French study reported on page 708 by Coste et al is important because it is concerned solely with that end point.3 As the authors make clear, their study has all the merits (large numbers) and demerits (different data collection staff, reporting errors, different laboratories) of a register based study, but it shows clearly that those patients treated earliest do best—and …

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