Evaluation of Insulin-Like Growth Factor-1 in Indian Growth Hormone-Deficient Children on Growth Hormone Therapy

Ekbote, Veena; Rustagi, Vaishakhi T.; Khadilkar, Vaman; Khadilkar, Anuradha; Chiplonkar, Shashi

doi:10.3109/07435800.2011.580443

Cited by 4 publications

(5 citation statements)

References 14 publications

(19 reference statements)

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“…Khadilkar et al [ 15 ] reported a similar mean IGF-1 of 84.09 ng/ml but higher mean IGF-1 SDS (−0.86) with a lower mean peak GH (0.71 ng/ml). A disparity from our result was observed by Ekbote et al ,[ 21 ] who reported a much lower mean IGF-1 (20 ng/ml), mean IGF-1 SDS (−3.40), and lower mean peak GH value (0.97 ng/ml) in IGHD patients. The contrast in findings may be explained by considering the fact that these studies included both IGHD and MPHD patients in the analysis and included only a small number of participants.…”

Section: Discussioncontrasting

confidence: 99%

Clinical and Biochemical Phenotype of Indian Children with Different Types of Idiopathic Growth Hormone Deficiency and their Association with Pituitary Height on MRI

Sharma

Mathur

Purwar

et al. 2021

Indian Journal of Endocrinology and Metabolism

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Background and Objectives: Differentiation of growth hormone deficiency (GHD) into various types has been made based on peak stimulated growth hormone levels and other hormone axis involvement. The data regarding how this classification is associated with variation in clinical and biochemical phenotype and how these findings associate with pituitary morphology remains sparse, especially in the Indian population. Therefore, we aimed to ascertain the differences in the pattern of auxological, clinical features including pituitary hypoplasia, and endocrinological profile among patients with severe GHD, partial GHD, and MPHD in the Indian population and to evaluate the association of pituitary height with various clinical and hormonal parameters. Materials and Methods: We conducted a cross-sectional study in 100 patients with idiopathic GHD. Patients were grouped into severe GHD, partial GHD, and MPHD to observe the differences in clinical, biochemical, and MRI findings. The pituitary height findings were correlated clinical and biochemical presentation. Results: MPHD subjects had a significantly higher frequency of breech delivery, neonatal jaundice, neonatal hypoglycemia, and micropenis. A significant difference was observed in the chronological age, bone age retardation (CA-BA), height SDS, weight SDS, peak GH response, IGF-1, IGF-1 SDS, and prevalence of pituitary hypoplasia, pituitary height, and pituitary height SDS among these three groups. In the composite population of GHD, pituitary height SDS was correlated with peak GH, basal IGF-I SDS, and body height SDS. Conclusion: The clinical and biochemical phenotype differs significantly among the various types of GHD. Pituitary height correlates with these findings and is helpful in further assessment of these patients.

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Section: Discussioncontrasting

confidence: 99%

Clinical and Biochemical Phenotype of Indian Children with Different Types of Idiopathic Growth Hormone Deficiency and their Association with Pituitary Height on MRI

Sharma

Mathur

Purwar

et al. 2021

Indian Journal of Endocrinology and Metabolism

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“…Poor standardization of these assays in commercial laboratories in India is yet another limitation. Although normative IGF-1 data for Indian children has been derived, it is seldom used in commercial laboratory reports [25]. …”

Section: Resultsmentioning

confidence: 99%

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

John¹,

Koledova

Kumar

et al. 2016

International Journal of Endocrinology

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In clinical practice, every year approximately 150,000 children are referred with short stature (SS) based on a cut-off of fifth percentile. The most important endocrine and treatable cause of SS is growth hormone deficiency (GHD). The lack of reliable data on the prevalence of GHD in India limits estimation of the magnitude of this problem. The diagnosis and treatment of GHD are hurdled with various challenges, restricting the availability of growth hormone (GH) therapy to only a very limited segment of the children in India. This review will firstly summarize the gaps and challenges in diagnosis and treatment of GHD based on literature analysis. Subsequently, it presents suggestions from the members at advisory board meetings to overcome these challenges. The advisory board suggested that early initiation of the therapy could better the chances of achieving final adult height within the normal range for the population. Education and awareness about growth disorders among parents, regular training for physicians, and more emphasis on using the Indian growth charts for growth monitoring would help improve the diagnosis and treatment of children with GHD. Availability of an easy-to-use therapy delivery system could also be beneficial in improving adherence and achieving satisfactory outcomes.

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“…There are several studies on the effects of growth hormone on short stature from India,[ 5 9 11 12 13 14 15 16 ] but none have compared the outcomes among different age groups to ascertain the maximum benefits [ Table 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike our study, the mean age of initiation of growth hormone in the Indian studies range from 8 to 13 yrs. [ 9 11 12 13 14 15 16 ] Early initiation resulted in better height outcomes and also proved to be financially better for the Indian parents as the cost is lesser in younger children due to lower doses.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] that included 96 children. Studies have reported better final height outcomes in children with GHD when started on rGH at younger age groups in comparison to older children,[ 6 7 8 9 ] however the mean age of initiation of rGH in Indian studies are between 9 and 12 years,[ 9 11 12 13 14 15 16 ] despite there being an additional support from the gonadal hormones in peripubertal children. This has been attributed mainly to the fact that during early diagnosis the growth compromise is lesser, and allows for better outcomes and also longer duration of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Early Initiation of Growth Hormone Therapy on Different Auxological Parameters in Growth Hormone Deficient Children

Kochar¹,

Ramachandran²,

Sethi³

2021

Indian Journal of Endocrinology and Metabolism

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Objectives: The aim of the study was to evaluate the efficacy of early initiation versus late growth hormone in improving the predicted adult height in growth hormone deficiency (GHD) children. Methods: A retrospective study of 550 GHD children with short stature, who had taken rGH for duration of minimum 12 months were included. They were divided into groups of less than 8 years and more than 8 years of age based on the initiation of growth hormone therapy. Their pretreatment and post-treatment auxological parameters were evaluated. Results: There were 148 children in less than 8 years group and 402 children in more than 8 years old group. In 8 years or younger age group, the pre-treatment mean height of –2.015 SDS improved to –0.7753 SDS after one year of treatment. There was an improvement in the mean height from –2.0447 SDS to –1.2658 SDS post-treatment in more than 8 years group. The pre- and post-treatment difference between the Z score of height, weight, and BMI were statistically significant (<0.001). Conclusion: A significant height improvement occurred in both the groups' children after 1 year of GH treatment but the gain in final adult height was better when initiated less than 8 years of age. No significant side effects were noted during this period.

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Evaluation of Insulin-Like Growth Factor-1 in Indian Growth Hormone-Deficient Children on Growth Hormone Therapy

Abstract: The change in serum IGF-1 z-scores in response to GHT in Indian children may not be a good indicator for monitoring growth hormone responsiveness.

Cited by 4 publications

References 14 publications

Clinical and Biochemical Phenotype of Indian Children with Different Types of Idiopathic Growth Hormone Deficiency and their Association with Pituitary Height on MRI

Clinical and Biochemical Phenotype of Indian Children with Different Types of Idiopathic Growth Hormone Deficiency and their Association with Pituitary Height on MRI

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

Effects of Early Initiation of Growth Hormone Therapy on Different Auxological Parameters in Growth Hormone Deficient Children

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