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Proefschrift binnenwerk Manon Ernst_DEF.indd

C H A N G E   I N   T O T A L   B O D Y  W A T E R   A S   A   P R E D I C T I V E   T O O L   F O R   G R O W T H   H O R M O N E   T R E A T M E N T   R E S P O N S E     composition   was   0.68   (p   =   0.001).   This   value   is   based   on   the   mean   difference   of   body  composition  before  start  of  rhGH  therapy  (TBW  /  Height2)  and  after  6  weeks   of  rhGH  therapy  (TBW  /  Height2)  within  the  GHD  group  and  within  the  SGA  group.       Table  1:     Baseline  characteristics     GHD   n=88   SGA   n=99   P-­‐value   Age  (years)   8.30  (±3.6)   6.68  (±2.5)     Height  before  therapy  (SDS)   -­‐2.74  (±0.99)   -­‐3.27  (±0.69)*   <0.001   Height  after  1  year  (SDS)   -­‐1.91  (±0.92)     -­‐2.40  (±0.73)*     <0.001   Mean  difference  in  height    (SDS1year  –  SDSstart)   0.832  (±0.50)     0.874  (±0.33)   0.509   Body  composition  before  therapy  (TBW/height2)   9.60  (±1.31)   9.02  (±1.06)*   <0.001   Body  composition  at  6  weeks  (TBW/height2)   10.54  (±1.39)     9.70  (±1.10)*     <0.001   Mean  difference  body  comp  (TBW/height2)   0.94  (±0.47)     0.68  (±0.47)*   0.001   Values  are  means  ±  standard  deviation   *  significant  difference  compared  to  GHD     Figure  1  shows  the  change  in  TBW  divided  by  height2  over  6  weeks,  plotted  against   the   change   in   height   during   one   year   (SDS)   for   the   GHD   children.   Two   lines   are   shown.   The   reference   line   on   the   x-­‐axis   represents   a   change   in   height   SDS   of   0.7,   which  is  the  cut  off  value  chosen  between  good  (n=51)  and  poor  (n=37)  respond-­‐ ers.   The   reference   line   on   the   y-­‐axis   represents   the   cut   off   value   of   the   change   in   TBW/height2   of  0.7  l/m2.  The  four  quadrants  represent  the  true  positive  (B),  false   negative   (C),   true   negative   (D)   and   false   positive   (A)   results.   Based   on   the   chosen   cut  off  values,  the  sensitivity  of  TBW/height2  was  87%  and  the  specificity  58%.  The   positive   and   negative   predictive   value   is   73%   and   75%   respectively.   The   same   is   done  in  figure  2  for  children  born  SGA,  in  which  25  had  a  poor  growth  response  and   74  had  a  good  growth  response  according  to  the  cut  off  value  of  0.7  SDS.  This  gives   a   sensitivity   of   53%   and   a   specificity   of   83%,   with   a   positive   predictive   value   of   90%   and   a   negative   predictive   value   of   32%   when   using   the   cut   off   value   of   TBW/height2  of  0.7  l/m2.       49  


Proefschrift binnenwerk Manon Ernst_DEF.indd
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