Background: Hypothyroidism in children leads to growth retardation. However, there is some evidence that recombinant human growth hormone (rhGH) therapy could suppress thyroid function. The most common observation in rhGH-treated patients is a decrease in thyroxine levels, which is reported as transient, but the studies in the field are inconsistent. We aimed to evaluate thyroid function in initially euthyroid children with idiopathic isolated GH deficiency during long-term rhGH therapy and to determine who is at a higher risk of thyroid function alterations during the therapy. Methods: The study group consisted of 101 children treated with rhGH for at least three years. Serum TSH and fT4 levels were determined at baseline, after the first six months and after each full year of therapy. The associations between changes in thyroid hormone levels during rhGH therapy and GH deficit, insulin-like growth factor-1 levels and growth response were investigated. Results: A significant decrease in fT4 levels (p = 0.01) was found as early as after the first six months of rhGH therapy. This effect persisted in the subsequent years of treatment without any significant changes in TSH values and tended to be rhGH dose related. Children with a greater fT4 decrease after the initiation of rhGH therapy were older, had higher bone age and responded to that therapy worse than children with lower fT4 changes. Conclusions: Our study revealed a long-term decrease in fT4 levels during rhGH therapy in initially euthyroid GHD children. The decrease in fT4 levels was associated with a lower growth response to rhGH therapy.

Short stature resulting from SGA is an obligatory indication for treatment with rhGH. The aim of the study was to assess the response to rhGH treatment in patients treated in the years 2016–2020 in six clinical centers in Poland. During the analysis, auxological data were collected, and anthropometrical parameters (Ht, SDS Ht, HV and ΔHV) were reassessed. Subgroups of patients with dysmorphic features (DYSM), fetal alcohol syndrome (FAS) and Silver-Russel syndrome (SRS) were selected. The study group consisted of 235 children (137 boys). The medium initial age was 9.08 years, and 190 patients were in the prepubertal stage. The poor response to treatment was defined as ΔHt SDS < 0.3 and/or ΔHV < 3 cm/year. Seventeen per cent of all patients after the first year and 44% after the second year met the ΔHt SDS < 0.3 criterion, and 56% during the first and 73% during the second year met the ΔHV < 3 cm/year criterion. Our data suggest that patients with SRS may show the best response to treatment, which was sustained throughout the follow-up period. The best response in all subgroups was observed during the first 12 months of therapy. Although the proportion of patients meeting the poor response criteria was high, only a few patients exceeded the 97th percentile for IGF-1 concentration during the first year of treatment. This might suggest that increasing the dose of rhGH in the second treatment year in order to sustain accelerated HV would be safe in these patients.

SUMMARY Introduction:The article concerns figure skating competitors. Figure skating is a very demanding discipline. It requires a combination of endurance, strength and flexibility. The training ground is ice, which puts strain on the muscles and skeleton. Young children often train more than is healthy for a young and growing body. The aim of the study was to determine the effect of training on the height and weight of female skaters. Material and methods: 181 measurements were taken from three skating clubs, and a survey was conducted among skaters' parents about skaters' siblings. Results:Female skaters are relatively shorter and lighter than their peers, but the differences were not statistically significant. Significant differences were noted between girls whose sisters do not do sports. Conclusion:The results suggest the influence of genetic factors and selection processes on the morphology of the skaters' body. Key words: biological development, body height, sports training, figure skating. STRESZCZENIE Wstęp:Łyżwiarstwo figurowe jest bardzo wymagającą dyscypliną sportu, kombinacją wytrzymałości, siły oraz gibkości. Podłożem treningowym jest lodowa tafla, co dodatkowo obciąża układ ruchu. Wysoki poziom dyscypliny sprawia, że coraz młodsi zawodnicy trenują w liczbie godzin wykraczającej poza normy uznane za bezpieczne dla młodego, wzrastającego organizmu. Celem pracy była ocena rozwoju biologicznego dziewczynek uprawiających łyżwiarstwo figurowe na podstawie analizy danych uzyskanych z pomiarów zawodniczek polskich klubów sportowych. Porównano także przebieg rozwoju młodych łyżwiarek do ich sióstr nieuprawiających tej dyscypliny sportu. Materiał i metody:Zebrano 181 pomiarów dziewcząt z 3 klubów łyżwiarskich oraz przeprowadzono ankiety wśród ich rodziców na temat rodzeństwa łyżwiarek. Wyniki: Zawodniczki są stosunkowo niższe i lżejsze od swoich rówieśniczek, jednak różnica ta nie jest istotna statystycznie. Odnotowano natomiast znaczne rozbieżności między dziewczynkami a ich siostrami, które nie trenowały żadnej dyscypliny sportowej. Wnioski: Wyniki pozwoliły również wnioskować o wpływie czynników genetycznych oraz selekcji na morfologię zawodniczek łyżwiarstwa figurowego. Słowa kluczowe: rozwój biologiczny, wysokość ciała, aktywność fizyczna, łyżwiarstwo figurowe. WSTĘPW Polsce coraz bardziej popularnym sportem staje się łyżwiar-stwo figurowe, które można uprawiać zarówno w formie rekreacyjnej, jak i wyczynowej. Według Banku Danych Lokalnych liczba osób trenujących tę dyscyplinę sportu w Polsce systematycznie się powiększa. Z ok. 400 osób trenujących w 1999 r. liczba ta wzrosła do ponad 1100 w 2010 r. [1]. Łyżwiarstwo figurowe jest sportem będącym kombinacją wytrzymałości, siły, gibkości i gracji z nutą artystyczną, wykonywanym na nienaturalnym podłożu, jakim jest lodowa tafla. Wysoki poziom dyscypliny zmusza coraz młodszych zawodników do treningów wykraczających poza normy uznane za bezpieczne dla mło-dego, wzrastającego organizmu [2]. Kariera zawodnika najczęściej zaczyna się w wieku 5-6 lat i kończy j...

The assessment of IGF-1 concentrations is one of the parameters used for evaluating response to rhGH treatment. An increase in IGF-1 concentration positively correlates with growth improvement, whereas IGF-1 concentrations significantly above the reference range may increase the risk of possible side effects. The aim of this study was to evaluate the IGF-1 local reference ranges for the rhGH treatment centers concerned and to compare these values with the population reference ranges. A retrospective analysis was conducted on auxological data from 229 SGA patients who received rhGH treatment between 2016 and 2020 at six university clinical centers in Poland. The IGF-1 levels were assessed at baseline, after 12 and 24 months, and compared to the reference ranges provided by the local laboratory and to the population reference ranges. After 12 months, 56 patients (24%) presented IGF-1 values > 97th percentile for the local reference range, whereas only 8 (3.5%) did so using the population reference ranges; p < 0.001. After 24 months of treatment, the values were: 47 (33%) > 97th percentile by local vs. 6 (4.2%) by population standards; p < 0.001. Thirty-nine patients had rhGH dose reduced after 12 months, of whom twelve (25%) had IGF-1 > 97th percentile according to the local reference ranges and five (13%) > 97th percentile for the population. Our data suggest that different methods used to determine IGF-1 concentration and the different IGF-1 reference ranges result in a significant proportion of rhGH-treated children with elevated IGF-1 concentration and experiencing dose reductions, which may negatively affect growth rate.