Changes in Bone Mineral Density, Body Composition, and Lipid Metabolism during Growth Hormone (GH) Treatment in Children with GH Deficiency

Boot, Annemieke M.

doi:10.1210/jc.82.8.2423

Cited by 115 publications

(165 citation statements)

References 38 publications

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“…PICP reflects the production of type I collagen that occurs during proliferation of osteoblast precursors cells and its synthesis is down-regulated when bone matrix mineralization is attained (27). Thus, the decline in OC and PICP levels that we showed after the first year of treatment could reflect a recovery of bone mineral density, as shown in children with GHD during GH therapy (33,34). However, it must be considered that PICP in serum is secreted not only from bone but also from fibroblasts (3,4).…”

Section: Discussionsupporting

confidence: 56%

“…Boot et al (33) showed a peak of OC and PICP at 6 months and a peak of ICTP at 1 year of GH treatment in children with GHD. After 2 years of treatment, according to our results, serum PICP levels significantly declined and serum ICTP levels did not change with respect to baseline values but, in contrast to our data, serum OC levels remained stable (33). Our results suggest that long-term GH treatment is associated with increased bone turnover mainly during the first year of therapy.…”

Section: Discussionsupporting

confidence: 46%

“…Our results suggest that long-term GH treatment is associated with increased bone turnover mainly during the first year of therapy. The stimulation of bone turnover induced by GH treatment could be a main cause of the acquisition of bone mineral density in children with GHD (33,34).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Dynamics of bone turnover in children with GH deficiency treated with GH until final height

Baroncelli

Bertelloni

Ceccarelli

et al. 2000

European Journal of Endocrinology

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Objective: To examine the dynamics of bone turnover in children with growth hormone deficiency (GHD) during long-term treatment. Design: We longitudinally measured growth velocity and serum concentrations of osteocalcin (OC), carboxyterminal propeptide of type I procollagen (PICP), and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in 24 patients with GHD during long-term GH treatment until final height (age: 7.7 Ϯ 0.7 and 16.9 Ϯ 0.5 years at baseline and at final height respectively). Results: At baseline, OC, PICP, and ICTP levels were significantly (P < 0.0001) reduced in comparison with prepubertal bone age-matched controls (10.2 Ϯ 2.3 mg/l and 22.5 Ϯ 7.6 mg/l; 187.8 Ϯ 26.2 mg/l and 328.4 Ϯ 74.3 mg/l; 7.7 Ϯ 2.0 mg/l and 14.2 Ϯ 1.3 mg/l respectively). During the first year of treatment mean levels of the bone markers increased significantly (P < 0.0001) with a peak at 12 months. After the first year of treatment, OC and PICP levels progressively declined, whereas ICTP levels remained stable until the final height; in any case, bone marker levels remained significantly higher (P < 0.03-P < 0.0001) than baseline. The change in bone marker levels at 6 and 12 months of treatment with respect to the baseline values was not related to growth rate during long-term treatment or final height. Conclusions:The results show that children with GHD have reduced bone turnover at baseline, and that long-term GH treatment is associated with a stimulation of bone turnover. OC, PICP, and ICTP do not predict growth rate during long-term treatment or final height in children with GHD.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionsupporting

confidence: 46%

See 1 more Smart Citation

Dynamics of bone turnover in children with GH deficiency treated with GH until final height

Baroncelli

Bertelloni

Ceccarelli

et al. 2000

European Journal of Endocrinology

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“…13,14 Impaired growth hormone secretion is frequent after cranial or total body irradiation for childhood cancer. 15,16 Growth hormone deficient children 17 and adults 18 are adipose, also when matched for BMI. Consequently, BMI is a less valid measure of adiposity in survivors of childhood cancer than in the background population.…”

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confidence: 99%

Degree of fatness after allogeneic BMT for childhood leukaemia or lymphoma

Nysom

Holm

Michaelsen

et al. 2001

Bone Marrow Transplant

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Summary:Excess fatness is frequent after childhood ALL treated without BMT. We measured the whole-body percent fat by dual-energy X-ray absorptiometry and the bodymass index (weight/height 2 (kg/m 2 ), BMI) in 25 survivors of childhood leukaemia or lymphoma (21 with ALL) who had received TBI and allogeneic BMT a median of 8 years ago (range 4-13). Adjusted for sex and age, the mean BMI was slightly but significantly reduced (0.4 s.d. below predicted) and the whole-body percent fat was significantly increased compared with healthy controls (1.1 s.d. above predicted). Eleven of 25 patients had a percent fat above the 90 percentile of the reference values, which indicates excess fatness. Adjusted for sex and age, a higher percent fat was related to additional cranial irradiation. Controlled for this, the whole-body percent fat seemed to be unrelated to age at BMT, length of follow-up, and previous chemotherapy. Compared with untransplanted ALL survivors treated with cranial irradiation, BMT survivors had significantly reduced BMI but similar whole body percent fat. BMI was a poor measure of body fatness in these patients. In conclusion, survivors of BMT for childhood leukaemia or lymphoma are adipose and slightly underweight and consequently have a substantially reduced lean body mass. Bone Marrow Transplantation (2001) 27, 817-820. Keywords: leukaemia; lymphoma; childhood; late sideeffects of therapy; body-mass index; body composition During the last decades the survival rates after childhood leukaemia and lymphoma have risen considerably. 1 For children with very high risk 2 or relapsed disease, 3-5 allogeneic BMT with a related donor will give the highest chance of survival. Unfortunately, allogeneic BMT for childhood cancer has frequent and severe delayed side-effects.Body-mass index (weight/height 2 (kg/m 2 ), BMI) is considered the best available weight-stature index in both chil- dren and adults, regarding independence of stature, correlation with body fat, and prediction of mortality. 6 Raised BMI (overweight) in childhood and adolescence increases the risk of being overweight in adulthood, 7,8 and overweight in adolescence 9 and adulthood 10,11 is associated with excess morbidity and mortality. In industrialised countries, the frequency of overweight people has increased over the last decades. 12 Whole-body dual-energy X-ray absorptiometry (DXA) is currently considered the most valid practically usable method for non-invasively measuring the body composition according to a three-compartment model based on bone mineral mass, fat mass, and non-fat non-mineral mass. 13,14 Impaired growth hormone secretion is frequent after cranial or total body irradiation for childhood cancer. 15,16 Growth hormone deficient children 17 and adults 18 are adipose, also when matched for BMI. Consequently, BMI is a less valid measure of adiposity in survivors of childhood cancer than in the background population. The BMI [19][20][21][22][23][24][25] and the degree of fatness 25-27 after childhood ALL treated without BMT have bee...

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“…*P!0.0001 compared with the population mean (0 SDS); † P!0.03: 1 year of combined treatment, compared with the start of GnRHa treatment; ‡ P!0.03: 3 months after the stop of GnRHa treatment, compared with the start of GnRHa treatment; § P!0.02: 3 months after the stop of GnRHa treatment, compared with 1 year of combined treatment. (27). In contrast to GnRHa, GH has well-documented lipolytic effects (28).…”

Section: Start Of Gnrha Treatment (Nz41)mentioning

confidence: 99%

Randomized GH trial with two different dosages in combination with a GnRH analogue in short small for gestational age children: effects on metabolic profile and serum GH, IGF1, and IGFBP3 levels

Kaay¹,

Bakker²,

Hulst³

et al. 2010

European Journal of Endocrinology

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Background: GnRH analogue (GnRHa) combined with GH treatment has been proposed to increase adult height. Effect on metabolic profile and GH, IGF1, and IGFBP3 levels in short small for gestational age (SGA) children is unknown. Objective: To assess fat mass and lean body mass SDS, percentage trunk fat, blood pressure (BP), insulin sensitivity (Si), b-cell function (disposition index, DI), lipid profile, and GH, IGF1, and IGFBP3 levels during 2 years of combined treatment. Subjects: Forty-one pubertal short SGA children with a mean (GS.D.) age of 12.1 (G1.0) years. Design: Children received 3.75 mg of leuprolide acetate depot subcutaneously every 4 weeks, and they were randomly assigned to receive 1 mg (group A) or 2 mg (group B) of GH/m 2 per day. Results: Percentage trunk fat increased in both groups, but to a lower extent in group B. Lean body mass SDS increased only in group B. Changes in BP, Si, DI, and lipids were similar in both groups. Si significantly decreased, but DI remained unchanged. Lipids remained normal. GH and IGF1 levels were significantly higher in group B. Conclusion: Our study is the first to report that 2 years of combined treatment with a GnRHa and either 1 or 2 mg GH/m 2 per day does not adversely affect body composition and metabolic profile of short SGA children who come under medical attention at the onset of puberty. There was a dose-dependent effect on fat mass SDS height , percentage trunk fat, lean body mass SDS height , and GH and IGF1 levels in favor of treatment with GnRHa and the higher GH dose of 2 mg/m 2 per day.

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Changes in Bone Mineral Density, Body Composition, and Lipid Metabolism during Growth Hormone (GH) Treatment in Children with GH Deficiency

Cited by 115 publications

References 38 publications

Dynamics of bone turnover in children with GH deficiency treated with GH until final height

Dynamics of bone turnover in children with GH deficiency treated with GH until final height

Degree of fatness after allogeneic BMT for childhood leukaemia or lymphoma

Randomized GH trial with two different dosages in combination with a GnRH analogue in short small for gestational age children: effects on metabolic profile and serum GH, IGF1, and IGFBP3 levels

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