Cross-sectional and prospective study of the effects of GH therapy on metabolic panel in children with GH deficiency

Ramistella, Vincenzo; Waśniewska, Małgorzata; Arasi, Stefania; Catena, Mariaausilia; Velletri, Maria Rosa; Corica, Domenico; Santucci, Simona; Luca, Filippo De

doi:10.4081/pmc.2014.104

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…GH replacement therapy improved these symptoms in adult GHD (14). In children, serum lipid profiles, lean body mass and bone mineral content were improved by one or two years of GH replacement therapy (15, 16). We postulate GH replacement therapy is effective for metabolic abnormalities caused by GHD; however, the efficacy of GH replacement therapy for metabolic abnormalities in those who exhibit growth in the absence of GH needs to be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Endocrine status of patients with septo-optic dysplasia: fourteen Japanese cases

Koizumi

Ida

Shoji

et al. 2017

Clin Pediatr Endocrinol

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Abstract.A clinical diagnosis of septo-optic dysplasia (SOD) is made when two or more of the classical triad of optic nerve hypoplasia, pituitary hormone abnormalities or midline brain defects. To date, a clinical study of SOD, regarding its endocrinological features in particular, has not been undertaken in Japan. We retrospectively evaluated 14 SOD patients at our institution. Hormonal dysfunction was present in 78% of cases: ten cases presented combined hypopituitarism and one case presented precocious puberty. GHD and hypothyroidism were the most common endocrinopathies. A thin pituitary stalk and a gradual decrease in hormone secretion were the main characteristics. SOD patients usually visited ophthalmologists during early infancy because of eye problems; however, the medical examination did not always lead to endocrine assessments being made. Consequently, children who have eye problems with optic nerve hypoplasia should undergo head MRI imaging. If diagnosed with SOD, it is very important to evaluate pituitary functions. Their endocrinological status should be followed for a long time, even if they do not exhibit any endocrinological problems at evaluation.

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Section: Discussionmentioning

confidence: 99%

Endocrine status of patients with septo-optic dysplasia: fourteen Japanese cases

Koizumi

Ida

Shoji

et al. 2017

Clin Pediatr Endocrinol

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“…Of interest, the cardiovascular risk factors improved in children with GHD during the observation period according to previous studies [38][39][40] . These findings support the hypotheses that untreated GHD in childhood is associated with a deterioration in cardiovascular risk factors [6] and, in consequence, with an increased cardiovascular risk as measurable by cIMT in adults [14,15,17] and children [18,23] .…”

Section: Discussionmentioning

confidence: 91%

Carotid Intima-Media Thickness in Children Treated with Growth Hormone: A Follow-Up Study over Three Years

et al. 2017

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Background: There is an ongoing discussion whether high doses of growth hormone (GH) may lead to cardiovascular diseases. Therefore, we studied the longitudinal relationships between GH treatment and carotid intima-media thickness (cIMT), which is predictive of the development of atherosclerosis. Methods: We measured blood pressure, lipids, hemoglobin HbA_1c, IGF-1, IGFBP-3, and cIMT in 28 children treated with supraphysiological doses of GH (mean age 9.8 ± 2.2 years, 39% males) and 36 children suffering from GH deficiency (GHD) and treated with physiological doses of GH (mean age 9.7 ± 2.2 years, 72% males) in a longitudinal study over 3 years. Results: The cIMT values did not change significantly in the observation period in children with GHD (Δmaximum and Δmean cIMT 0.0 ± 0.1 mm). The mean (+0.1 ± 0.1 mm) but not the maximum cIMT (0.0 ± 0.1 mm) increased significantly (p = 0.049) in the children treated with supraphysiological doses of GH. Blood pressure, lipids, and HbA_1c were not related to cIMT, while IGF-1, IGFBP-3, body mass index expressed as a standard deviation score, and treatment duration correlated significantly with cIMT. Conclusions: We did not find any robust evidence that GH treatment is associated with changes in cIMT. Further studies are necessary to analyze the impact of IGF-1 and IGFBP-3 concentrations on cIMT.

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“…Radetti et al reported normalization of glucose tolerance in 5 out of 128 children who already presented impaired glucose tolerance before starting GHT ( 57 ), while unchanged glucose levels have been found in the majority of studies (14/21; 66.6%) ( 12 , 15 , 26 , 52 , 58 , 59 , 61 , 65 , 66 , 70 , 75 – 77 ).…”

Section: Resultsmentioning

confidence: 99%

Glucose Metabolism in Children With Growth Hormone Deficiency

Ciresi

2018

Front. Endocrinol.

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BackgroundThe growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis has a fundamental impact on glucose metabolism. Therefore, both untreated GH deficiency (GHD) and GH treatment (GHT) may be associated with some metabolic alterations, although the abnormalities of glucose metabolism have been investigated by relatively few studies as main outcomes.AimThe present review summarizes the available data on glucose metabolism in children with GHD, providing an overview of the current state of the art in order to better clarify the real metabolic impact of GHD and GHT.MethodsAmong all the existing studies, we evaluated all original studies that fulfilled our criteria for analysis reporting parameters of glucose metabolism as the primary or secondary objective.ResultsThe reported impact of GHD per se on glucose metabolism is quite homogeneous, with the majority of studies reporting no significant difference in metabolic parameters between GHD children and controls. Conversely, GHT proves to be more frequently associated with a subtle form of insulin resistance, while both fasting glucose and HbA1c levels remain almost always within the normal range.ConclusionThe different methods to study glucose metabolism, the heterogeneity of the populations evaluated, the different doses of GH used together with the variable duration of follow-up may be responsible for discrepancy in the results. Long-term longitudinal studies having glucose homeostasis as their primary outcome are still needed in order better to clarify the real metabolic impact of GHD and GHT in children.

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Cross-sectional and prospective study of the effects of GH therapy on metabolic panel in children with GH deficiency

Cited by 8 publications

References 16 publications

Endocrine status of patients with septo-optic dysplasia: fourteen Japanese cases

Endocrine status of patients with septo-optic dysplasia: fourteen Japanese cases

Carotid Intima-Media Thickness in Children Treated with Growth Hormone: A Follow-Up Study over Three Years

Glucose Metabolism in Children With Growth Hormone Deficiency

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