Growth hormone replacement may influence the biological action of thyroid hormone on liver and bone tissue

Glynn, Nigel; Halsall, David; Boran, Gerard; Cook, Paul; McDermott, John; Smith, Diarmuid; Tormey, William; Thompson, Christopher J.; O'Gorman, Donal J.; McKenna, Malachi J.; Agha, Amar

doi:10.1016/j.ghir.2021.101393

Cited by 9 publications

(12 citation statements)

References 49 publications

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“…The effects of rhGH therapy on thyroid function and thyroid hormone metabolism have been previously analyzed by several authors not only in GH-deficient children [ 5 , 12 , 14 , 15 , 17 , 18 , 20 , 23 , 26 , 27 , 31 , 32 ] and adults [ 1 , 6 , 19 , 22 , 24 , 28 , 33 , 34 , 35 , 36 , 37 , 38 ] but also in healthy athletes and body builders [ 39 , 40 ]. The number of studies evaluating thyroid function in pediatric GH-deficient patients published in the last twenty years is limited.…”

Section: Discussionmentioning

confidence: 99%

Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

Witkowska–Sędek

Kucharská

Rumińska

et al. 2021

JCM

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Background: Hypothyroidism in children leads to growth retardation. However, there is some evidence that recombinant human growth hormone (rhGH) therapy could suppress thyroid function. The most common observation in rhGH-treated patients is a decrease in thyroxine levels, which is reported as transient, but the studies in the field are inconsistent. We aimed to evaluate thyroid function in initially euthyroid children with idiopathic isolated GH deficiency during long-term rhGH therapy and to determine who is at a higher risk of thyroid function alterations during the therapy. Methods: The study group consisted of 101 children treated with rhGH for at least three years. Serum TSH and fT4 levels were determined at baseline, after the first six months and after each full year of therapy. The associations between changes in thyroid hormone levels during rhGH therapy and GH deficit, insulin-like growth factor-1 levels and growth response were investigated. Results: A significant decrease in fT4 levels (p = 0.01) was found as early as after the first six months of rhGH therapy. This effect persisted in the subsequent years of treatment without any significant changes in TSH values and tended to be rhGH dose related. Children with a greater fT4 decrease after the initiation of rhGH therapy were older, had higher bone age and responded to that therapy worse than children with lower fT4 changes. Conclusions: Our study revealed a long-term decrease in fT4 levels during rhGH therapy in initially euthyroid GHD children. The decrease in fT4 levels was associated with a lower growth response to rhGH therapy.

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Section: Discussionmentioning

confidence: 99%

Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

Witkowska–Sędek

Kucharská

Rumińska

et al. 2021

JCM

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“…Among adults with postoperative GH deficiency, recombinant human GH treatment increased significantly Lp(a) levels at 12 months posttreatment, independently of baseline Lp(a) levels and apo(a) isoforms [ 119 ]. More recently, a prospective observational study demonstrated that a GH replacement therapy in men with GH deficiency resulted in a significant increase in Lp(a) levels (mean: from 27.4 nmol/L to 34.3 nmol/L) [ 120 ]. There were no correlations between baseline Lp(a) levels (or the increase) and concentrations of TH or insulin-like growth factor-1 [ 120 ].…”

Section: Sex-specific Differences and Hormonesmentioning

confidence: 99%

“…More recently, a prospective observational study demonstrated that a GH replacement therapy in men with GH deficiency resulted in a significant increase in Lp(a) levels (mean: from 27.4 nmol/L to 34.3 nmol/L) [ 120 ]. There were no correlations between baseline Lp(a) levels (or the increase) and concentrations of TH or insulin-like growth factor-1 [ 120 ].…”

Section: Sex-specific Differences and Hormonesmentioning

confidence: 99%

Non-genetic influences on lipoprotein(a) concentrations

Enkhmaa

Berglund

2022

Atherosclerosis

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“…Several studies have revealed the effect of GH replacement therapy on thyroid function, where GH replacement altered the peripheral interconversion of thyroxine (T4) and triiodothyronine (T3). 29 Additionally, GH treatment increased serum T3 or free FT3 30,31 and decreased T4 or free T4. Yamauchi 32 revealed that GH mediated and stimulated increased FT3 secretion by up-regulating iodothyronine deiodinase type-2.…”

Section: Discussionmentioning

confidence: 99%

A Real-World Study of Recombinant Human Growth Hormone in the Treatment of Idiopathic Short Stature and Growth Hormone Deficiency

Gou

Cheng

Leng

et al. 2022

TCRM

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Objective: This study aimed to evaluate the clinical efficacy of recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and growth hormone deficiency (GHD) and to explore the related factors affecting treatment efficacy. Methods:The current research reflects a real-world study. A total of 79 patients with ISS and 95 patients with GHD (both groups pre-puberty) who had been treated with rhGH for more than one year from January 2010 to September 2019 were included in this study. The patients were divided into two groups, ie, an ISS and a GHD group, respectively. The growth indexes, such as chronological age (CA), bone age (BA), height standard deviation score (HtSDS), insulin-like growth factor-1 (IGF-1) SDS, and body mass index were recorded and compared between the two groups before and after treatment. The treatment efficacy was evaluated according to changes in HtSDS before and after treatment, and the influencing factors of clinical efficacy were analyzed using a multivariate regression model. Results: At the start of treatment, the differences in CA, BA, height, weight, sexual development stage, HtSDS, mid-parental height SDS, and IGF-1 SDS between the two groups were not statistically significant (P > 0.05). However, the initial dose of rhGH in the GHD group was significantly lower than in the ISS group (P < 0.001). Following rhGH treatment, the differences in CA, BA, BA/CA ratio, and IGF-1 SDS measured at 6, 12, 18, and 24 months between the ISS and GHD groups were not statistically significant, while the difference in HtSDS measured at 6 months was statistically significant. With the extension of rhGH treatment time, the annual growth rate (GV) gradually decreased, and the difference between HtSDS and the baseline gradually increased; however, the differences between the ISS and GHD groups were not statistically significant. The most important factor affecting the treatment efficacy for patients with ISS was age at the start of treatment; the most important factors affecting the treatment efficacy for patients with GHD were age and IGF-1 SDS. Conclusion: Recombinant human growth hormone treatment can significantly improve the height of patients with ISS and GHD. There was no significant difference in growth rate between patients with ISS and those with GHD at relatively high doses. The common factor affecting the treatment efficacy of the two groups was the age at the start of treatment. During treatment, monitored data indicated that rhGH treatment of GHD and ISS thyroid function showed a clinical phenomenon in the form of increased free triiodothyronine, rather than hypothyroidism, which was rarely reported in existing studies.

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Growth hormone replacement may influence the biological action of thyroid hormone on liver and bone tissue

Cited by 9 publications

References 49 publications

Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

Non-genetic influences on lipoprotein(a) concentrations

A Real-World Study of Recombinant Human Growth Hormone in the Treatment of Idiopathic Short Stature and Growth Hormone Deficiency

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