Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment

Cutfield, Wayne S.; Wilton, Patrick; Bennmarker, Helge; Albertsson‐Wikland, Kerstin; Chatelain, Pierre; Ranke, Michael B.; Price, David A.

doi:10.1016/s0140-6736(99)04055-6

Cited by 292 publications

(171 citation statements)

References 17 publications

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“…It is well known, in fact, that GH excess has a negative influence on glucose tolerance, and recently it has been reported that GH treatment of GHD children can advance the onset of diabetes mellitus, at least in an already predisposed population (18). We did not find, however, any signs of glucose intolerance in our patients.…”

Section: Discussioncontrasting

confidence: 57%

Treatment of GH-deficient children with two different GH doses: effect on final height and cost-benefit implications

Radetti

Buzi²,

Paganini³

et al. 2003

Eur J Endocrinol

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Objective: Treatment of GH-deficient (GHD) children with higher doses of recombinant human GH (rhGH) than conventional ones has been reported to result in higher growth velocity and increased final height. These findings, however, were observed by comparing large but heterogeneous groups of children. We wanted to verify whether the same results could be obtained in two groups of appropriately well-matched children with isolated GHD treated with high vs conventional doses of rhGH. Methods: Out of two cohorts of GHD children, cohort A (on a weekly rhGH dose of 0.3 mg/kg body weight) and cohort B (on a weekly rhGH dose of 0.15 mg/kg body weight), we selected two groups, each including 13 patients, who before treatment were matched for age, sex and height standard deviation score (SDS). They were followed up until final height. Results: Final height SDS was significantly higher in group A ð20:45^0:36 (S.D.) vs 21:07^0:7; P ¼ 0:008Þ; as well as height gain SDS ð1:81^0:58 vs 1:23^0:62; P ¼ 0:002Þ: The difference between final height SDS and target height SDS was positive only in group A and significantly higher in group A than in group B ð0:33^0:51 vs 20:46^0:7; P ¼ 0:01Þ: Glucose tolerance was always normal in the group treated with higher doses. Conclusion: The final height of children treated with higher doses of rhGH is increased, also in relation to their genetic target. The economical burden of this choice of treatment, however, has to be taken into account when evaluating the results.

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Section: Discussioncontrasting

confidence: 57%

Treatment of GH-deficient children with two different GH doses: effect on final height and cost-benefit implications

Radetti

Buzi²,

Paganini³

et al. 2003

Eur J Endocrinol

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“…Unnecessary treatment must be avoided, because treatment risks, albeit small, do exist (26)(27)(28), and the costs of treatment are high.…”

Section: Discussionmentioning

confidence: 99%

Central reassessment of GH concentrations measured at local treatment centers in children with impaired growth: consequences for patient management

Hauffa

Lehmann

Bettendorf

et al. 2004

European Journal of Endocrinology

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Objective: GH deficiency is diagnosed in children if serum GH fails to rise above a predefined cutoff value in response to at least two stimuli. Diagnostic decisions based on this testing are highly variable between centers and depend on the GH assays used. Considering the large spectrum of commercially available GH assays, we wanted to evaluate the agreement between assays, and to test whether assayrelated variability of diagnostic decisions could be reduced by reassessment of peak GH concentrations in a reference center. Design: We reanalysed 699 peak GH serum samples obtained after GH testing of 382 children and adolescents from 19 centers using three reference assays and compared these results with those obtained with the local assays. A subgroup of 132 patients tested with the combination of insulin hypoglycemia test and arginine test was evaluated for changes in the assignment to the diagnostic group of GH deficiency. Results: The mean difference between methods ranged from 5.4 to 10.3 mU/l, slopes of the regression lines from 1.28 to 1.65. Significant non-linearity was detected in five of six assay comparisons, indicating that most assay results cannot be interconverted by the use of a factor. Overall agreement between reference and local assays was only moderate. Significant changes in diagnostic assignment occurred when different assays were used on the same patient (P , 0.0001 -P , 0.0023). Based on GH remeasurement by one reference assay, 36 of 132 patients were categorized differently, with 35 patients changing into the GH-deficient group. Similar findings were obtained with the other reference assays. Conclusions: To decrease variability in GH testing related to assays and cutoff values, we recommend nationwide reassessment of GH peak sera in reference centers. Decisions to treat GH deficiency should incorporate the reference center results.European Journal of Endocrinology 150 291-297

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“…In children, data from the Pfizer International Growth Database (KIGS) reported that GH treatment in children might induce a very modest increase in the incidence of type 2 DM (26). The effect of GH on glucose metabolism is, however, considerably different in adults compared with that seen in children.…”

Section: Type 2 Diabetes Mellitusmentioning

confidence: 99%

Safety aspects of GH replacement

Svensson¹,

Bengtsson²

2009

European Journal of Endocrinology

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In adults, GH replacement therapy will often be maintained for decades. Owing to the long duration of GH replacement in many adults, it is essential to establish the long-term safety aspects of the treatment. In this review, studies that have investigated the safety profile of long-term GH replacement will be reviewed with an emphasis on studies based on data from the Pfizer International Metabolic Database (KIMS). These studies show that long-term GH replacement in adults is safe and that long-term GH replacement may even improve cardiovascular mortality and morbidity in GH-deficient adults.

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Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment

Cited by 292 publications

References 17 publications

Treatment of GH-deficient children with two different GH doses: effect on final height and cost-benefit implications

Treatment of GH-deficient children with two different GH doses: effect on final height and cost-benefit implications

Central reassessment of GH concentrations measured at local treatment centers in children with impaired growth: consequences for patient management

Safety aspects of GH replacement

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