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Proefschrift binnenwerk Manon Ernst_DEF.indd

C H A P T E R   3   the   growth   response   was   negatively   correlated   with   chronological   age   and   height   SDS,  and  positively  correlated  with  target  height  SDS,  rhGH  dose  (IU/kg/week)  and   frequency  of  GH  injections.  In  this  study  only  GHD  children  are  examined.  Furtado   et   al.18 found   the   same   response   in   SGA   children.   In   this   study   rhGH   therapy   was   associated   with   a   first   year   height   increment   of   0.67   SDS   (p   <   0.01).   Ranke   et   al   found   the   following   results   for   small   for   gestational   age   children,   treated   with   GH   treatment:  Mean  height  velocity  was  8.7  and  7.0  cm/year,  corresponding  to  a  height   increment   of   0.7   and   0.3   SD   scores,   in   the   first   and   second   year   of   GH   treatment,   respectively19.       The   rhGH   dose   which   was   given   in   our   study   is   35   microgram/kilogram   for   GHD   and  for  SGA  children.  When  taking  the  cut  off  value  of  0.7  SDS  for  granted,  we  found   the   best   results   at   a   cut   off   value   of   0.7   l/m2   for   the   change   in   body   composition,   because  at  this  level  the  number  of  correct  predictions  was  the  highest.  In  the  pre-­‐ vious  study  of  Hoos  et  al.13,  the  best  result  was  found  at  a  cut  off  value  of  0.9  l/m2   for  the  change  in  body  composition.     Statistics   We  used  a  cut  off  value  of  0.7  l/m2   for  the  change  in  body  composition,  because  at   this  level  the  highest  and  the  maximum  sensitivity  and  specificity  was  reached.  This   value   has   been   detected   by   calculating   the   sensitivity   and   specificity   for   different   cut  off  values.     Sensitivity  was  calculated  by:  Number  of  true  positives  /  (Number  of  true  positives   +   Number   of   false   negatives).   Specificity   was   calculated   by:   Number   of   true   nega-­‐ tives  /  (Number  of  true  negatives  +  Number  of  false  positives).       Two  sample  t-­‐tests  were  used  to  evaluate  differences  between  two  groups.   Results   In   total   192   children   were   included,   of   which   five   patients   dropped   out   because   they  stopped  treatment  due  to  poor  compliance  or  did  not  appear  on  appointments.   Of   the   remaining   187   patients,   88   patients   were   GHD   and   99   were   SGA.   Patient   characteristics   are   given   in   Table   1.   The   children   were   divided   into   two   groups   according   to   their   diagnosis.   There   was   an   increase   in   height   of   0.832   and   0.874   SDS   after   one   year   of   treatment   in   respectively   the   GHD   and   the   SGA   children,   which  is  not  significantly  different.  The  body  composition  according  to  the  calcula-­‐ tion  of  TBW  divided  by  height2  in  SGA  children  was  significantly  lower  compared  to   the  GHD  children  (9.02  l/m2  and  9.6  l/m2,  p  <  0.001).  The  change  in  body  composi-­‐ tion  within  the  GHD  group  was  0.94  and  within  the  SGA  children  the  change  in  body   48    


Proefschrift binnenwerk Manon Ernst_DEF.indd
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