Changes in body composition in male adolescents with childhood‐onset GH deficiency during transition

Binder, Gerhard; Donner, Julia; Becker, Bettina; Bauer, Jana Leonie; Schweizer, Roland

doi:10.1111/cen.14041

Cited by 9 publications

(16 citation statements)

References 30 publications

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“…After the first screening, based on title and abstract, 52 full-text articles were selected for assessment of eligibility. After this second screening process, a total of 15 articles were considered eligible for this review ( 17 – 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies did not specify which stimulation tests were used ( 19 , 21 , 22 , 27 – 29 ). The diagnosis of GHD was based on a peak GH value of <10 ng/mL in eight studies ( 17 , 20 , 22 , 24 – 27 , 29 ), <5 ng/mL in one study ( 31 ), and <3 ng/mL in another ( 18 ). The maximum GH concentration limit required for a diagnosis of GHD was not specified in five studies ( 19 , 21 , 23 , 28 , 30 ).…”

Section: Resultsmentioning

confidence: 99%

“…Six of these studies had a follow-up period greater than 1 year. In four studies, body composition was assessed at the end of therapy and reassessed 0.5–2 years after treatment had stopped ( Table 2 ) ( 17 , 19 , 23 , 30 ).…”

Section: Resultsmentioning

confidence: 99%

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The influence of growth hormone on pediatric body composition: A systematic review

Ferruzzi

Vrech²,

Pietrobelli³

et al. 2023

Front. Endocrinol.

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BackgroundGrowth hormone (GH) affects metabolism and regulates growth in childhood. The most prominent feature of GH deficiency (GHD) in children is diminished height velocity that eventually leads to short stature. In adult-onset GHD, lean body mass (LBM) is reduced, and visceral fat mass (FM) increased. Beneficial effects of GH treatment on body composition in adults with GHD, including an increase in muscle mass and a decrease in FM, are well established. Relatively few studies have investigated the effects of GH treatment on the body composition of pediatric patients with idiopathic or hypothalamic-pituitary disease-associated GH deficiency. This systematic review aimed to summarize available evidence relating to the effects of GH treatment on body composition in children with GHD.MethodsThe PubMed, Science Direct, Cochrane Trials, and Embase databases, were searched with keywords including “GH”, “body composition”, “children”, and “growth hormone” for English-language articles, published between January 1999 and March 2021. Two reviewers independently evaluated the search results and identified studies for inclusion based on the following criteria: participants had a confirmed diagnosis of GHD (as defined in each study); participants were pediatric patients who were receiving GH or had stopped GH treatment, regardless of whether they were pre- or post-pubertal; the intervention was recombinant human GH (rhGH; somatropin); and outcomes included changes in body composition during or after stopping GH therapy. Data extracted from each study included study quality, study sample characteristics, study interventions, and body composition. Data on fat-free mass and LBM were combined into a single category of LBM.ResultsSixteen studies reporting changes in body composition (i.e., FM and LBM) associated with GH treatment in children with GHD were identified and included in the review. Collectively, these studies demonstrated that FM decreased, and LBM increased in response to GH replacement therapy.ConclusionDespite study limitations (i.e., potential effects of diet and physical activity were not considered), we concluded that a periodic body composition assessment is required to ensure that a satisfactory body composition is achieved during GH replacement therapy in children with GHD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The influence of growth hormone on pediatric body composition: A systematic review

Ferruzzi

Vrech²,

Pietrobelli³

et al. 2023

Front. Endocrinol.

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“…In the present study, patients’ BMI Z-scores increased, whereas their IGF-1 and IGFBP-3 levels decreased during the GH treatment interruption period; however, their BMI Z-scores did not improve even after 1 year of GH replacement therapy. Several studies have reported that GH treatment discontinuation during the transition period led to an increase in BMI [ 23 ] and fat mass, in addition to a decrease in lean body mass [ 11 , 24 , 25 ]. Although the present study could not evaluate the body composition in detail, the increased BMI Z-scores in the cohort suggest that GH treatment discontinuation influences adiposity.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency

et al. 2022

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Background: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.Methods: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.Results: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.Conclusion: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.

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“…In accordance to our results, other studies demonstrated that recommencement of rhGH in TP with the duration of 1–2 years manifested as significant LBM increase (6–14%) and FM reduction (7–12%). Discontinuation of rhGH treatment for 6–24 months in COGHD adolescents after final height achievement resulted in FM increase (10–17%) and LBM decrease by up to 8% ( 3 , 8 , 30 , 31 , 32 , 33 , 34 , 35 ). By contrast, a few studies reported no difference in BC parameters after 6–24 months period of rhGH after growth completion ( 4 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Mapping the journey of transition: a single-center study of 170 childhood-onset GH deficiency patients

Doknic

Stojanović

Soldatović

et al. 2021

Endocrine Connections

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Objective: To analyze metabolic parameters, body composition (BC) and bone mineral density (BMD) in childhood onset GH deficiency (COGHD) patients during transition period (TP). Design: Single center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2±2.0 years, range 16-25) transferred after growth completion from two pediatric clinics to adult endocrine unit. Two separate analyses were performed: 1) cross-sectional analysis of hormonal status, metabolic parameters, BC and BMD at first evaluation after transfer from pediatrics to adult department; 2) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP. Results: COGHD was of a congenital cause (CONG) in 50.6% subjects, tumor related (TUMC) in 23.5% and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (p<0.01) and lower Z score at L-spine (p<0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrated lower fat mass and increased BMD compared to rhGH-untreated group (p<0.01). Three years of rhGH after growth completion resulted in significant increase in lean body mass (12.1%) and BMD at L-spine (6.9%), parallel with decrease in FM (5.2%). Conclusion: The effect of rhGH in childhood is invaluable for metabolic status, BC and BMD in transition to adulthood. Tumor related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BD and BMD in patients with persistent COGHD.

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Changes in body composition in male adolescents with childhood‐onset GH deficiency during transition

Cited by 9 publications

References 30 publications

The influence of growth hormone on pediatric body composition: A systematic review

The influence of growth hormone on pediatric body composition: A systematic review

Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency

Mapping the journey of transition: a single-center study of 170 childhood-onset GH deficiency patients

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