Effect of growth hormone on height, weight, and body composition in Prader-Willi syndrome

Abstract

Aims-To evaluate the eVect of the administration of growth hormone on stature, body weight, and body composition in children aged between 4 and 10 years with Prader-Willi syndrome. Methods-Height, weight, and skinfold thickness were recorded in 25 children using standard anthropometric techniques at recruitment, and six months later, shortly before the start of daily subcutaneous injections of growth hormone. Body composition was assessed via a measurement of total body water using stable isotopes. Measurements were repeated at the end of the six months of growth hormone administration. Measurements of height, weight, and skinfold thickness were expressed as standard deviation scores (SDSs). Results-There was a significant reduction in the percentage of body fat after growth hormone treatment; height velocity doubled during treatment; body weight did not change significantly when expressed as an SDS. Skinfold thickness at both the triceps and subscapular site decreased in absolute terms and when expressed as an SDS. Conclusions-These results indicate suYcient potential benefit to justify a more prolonged trial of growth hormone treatment and an exploration of diVerent dosage regimens in children with PraderWilli syndrome. (Arch Dis Child 1998;78:474-476)

Body composition in Prader-Willi syndrome compared with nonsyndromal obesity: Relationship to physical activity and growth hormone function

“…36,37 In adults, GHD is associated with shrinking of the ICW compartment, possibly as a result of protein catabolism. 10,38 The higher ECW/ICW ratio in the group with PWS seems to support the hypothesis of functional GHD.…”

Effects of Growth Hormone Therapy on Glucose Metabolism and Insulin Sensitivity Indices in Prepubertal Children with Prader-Willi Syndrome

“…However, it has been demonstrated that in PWS patients GH treatment (GHT) reduces fat mass and increases body free fat mass percentage [4,12,13,14], improves respiratory muscle strength and endurance [15], and increases resting metabolic rate as well as physical strength and agility[14]. Changes in behaviour have also been observed [16] and beneficial effects on growth velocity have been demonstrated in many studies [6,12,13,14]. …”

Síndrome de Prader-Willi: aspectos metabólicos associados ao tratamento com hormônio de crescimento

“…O tratamento destes pacientes com rhGH pode melhorar a estatura final, porém a grande contribuição do GH tem sido a melhora da composição corpórea, minimizando as conseqüências clínicas desta síndrome (28)(29)(30). Em nossos pacientes, observamos aumento da velocidade de crescimento, principalmente no primeiro ano de tratamento, porém acompanhado de um avanço proporcional na idade óssea.…”

“…Os resultados sugerem que o tratamento propicia efeitos benéficos na aparência físi-ca, energia e resistência, melhorando assim a inserção psicossocial das crianças afetadas (16,29,40). Muitas destas observações foram relatadas espontaneamente pelos pais.…”