Metabolic differences between short children with GH peak levels in the lower normal range and healthy children of normal height

Tidblad, Anders; Gustafsson, Jan Åke; Marcus, Claude; Ritzén, Martin; Ekström, Klas

doi:10.1016/j.ghir.2017.04.001

Cited by 3 publications

(8 citation statements)

References 45 publications

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“…Although the specific mechanism for the relationship between BMISDS and SBP remains unclear, we considered based on our findings that this relationship may differ based on the degree of GHD. A previous study showed that metabolic index did not differ between patients with GH peaks above 7 ng/ml and people with normal GH peaks, while a significant difference existed between patients with SGHD and an unaffected population 11 . Abdominal fat accumulation is a main metabolic feature of GHD, which may lead to abdominal obesity 10 .…”

Section: Discussionmentioning

confidence: 87%

“…GHD is a common cause of linear growth restriction in children, and the diagnosis of GHD mainly relies on clinical manifestations combined with the GH provocation test. There are significant differences in body composition and metabolic traits between patients with severe GHD (SGHD) and the general population 11 . According to the criteria for SGHD 10–12 , this study defined SGHD as a GH peak <5 ng/ml.…”

Section: Introductionmentioning

confidence: 99%

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Growth hormone peak modifies the effect of BMI on increased systolic blood pressure in children with short stature

Zhang

et al. 2019

Sci Rep

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Blood pressure (BP), especially systolic BP (SBP), is higher in adult growth hormone deficiency (AGHD) patients than in normal controls. Additionally, obesity is a known risk factor for hypertension, and growth hormone deficiency (GHD) is an important cause of short stature. For children with GHD, attention has been directed solely towards height. Few studies have assessed its potential impact on BP. Here, we investigated the effect of body mass index standard deviation score (BMISDS) on BP in children with short stature. This study included 736 children with short stature divided into two groups based on peak growth hormone (GH) level in GH provocation tests [severe GHD (SGHD) group = 212 children; non-SGHD group = 524 children]. We found that SBP was significantly higher in the SGHD group than in the non-SGHD group ( p = 0.045). Additionally, there was a significant positive association between BMISDS and SBP in the SGHD group (β = 3.12, 95% CI: 1.40–4.84, p < 0.001), but no association between these variables was observed in the non-SGHD group. Thus, SGHD patients had a higher SBP than non-SGHD patients. BMISDS is a significant factor for higher SBP in SGHD patients but not in non-SGHD patients.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Growth hormone peak modifies the effect of BMI on increased systolic blood pressure in children with short stature

Zhang

et al. 2019

Sci Rep

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“…A detailed description of the different laboratory and metabolic examinations carried out during the study has previously been published [14]. In summary, the participants were evaluated every 3 months with clinical examination, auxological measurements, and fasting blood samples of glucose, insulin, IGF-I, and HbA1c.…”

Section: Methodsmentioning

confidence: 99%

“…The rationale for treatment is thus not only improvement of height but also correction of these disturbances in patients with severe GHD. In a previous study, we investigated whether such disturbances also could be detected in short children in the normal to lower range of GH secretion but above the conventional threshold of GHD [14]. There were few differences in comparison with an age- and sex-matched healthy control group, but in a sub-analysis of those with lowest peak GH secretion, differences regarding insulin sensitivity and insulin-like growth factor I (IGF-I) could be demonstrated [14].…”

Section: Introductionmentioning

confidence: 99%

“…In a previous study, we investigated whether such disturbances also could be detected in short children in the normal to lower range of GH secretion but above the conventional threshold of GHD [14]. There were few differences in comparison with an age- and sex-matched healthy control group, but in a sub-analysis of those with lowest peak GH secretion, differences regarding insulin sensitivity and insulin-like growth factor I (IGF-I) could be demonstrated [14]. In this study, the same cohort of children was randomized to receive 3 different doses of rhGH for 2 years in order to investigate how rhGH treatment influences different metabolic parameters.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Effects of Growth Hormone Treatment in Short Prepubertal Children: A Double-Blinded Randomized Clinical Trial

et al. 2020

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Introduction: Growth hormone (GH) is a central hormone for regulating linear growth during childhood and also highly involved in the metabolism of lipids, carbohydrates, and protein. However, few studies report on how treatment with GH during childhood influences metabolic parameters. Our aim was to investigate metabolic effects of different doses of GH in short children with GH peak levels in the low to normal range. Design: Thirty-five prepubertal short children (<−2.5 SDS), aged 7–10 years, with peak levels of GH between 7 and 14 μg/L during an arginine-insulin tolerance test, were randomized to 3 different doses (11/33/100 μg/kg/day) of GH treatment for 2 years. Auxological and metabolic investigations were performed. These included metabolites in blood and interstitial microdialysis fluid, dual-energy X-ray absorptiometry, frequently sampled intravenous glucose tolerance test (FSIVGTT), and stable isotope examinations of rates of glucose production and lipolysis. Results: At 24 months, the high-dose group (HD) had higher fasting insulin compared with the standard-dose (SD) and low-dose (LD) groups (HD: 111.7 vs. SD: 61.2 and LD: 46.0 pmol/L [p < 0.001]) and showed signs of insulin resistance (HOMA-IR, HD: 4.20 vs. SD: 2.17 and LD: 1.71 (LD) [p < 0.001]). The FSIVGTT also demonstrated higher acute insulin response (p < 0.05). Few other metabolic differences were found at 24 months, but a decreased insulin sensitivity index (Si) could already be seen at 12 months for both SD and HD compared with the LD group (p < 0.05). Conclusion: Treatment with GH resulted in a dose-dependent decrease in insulin sensitivity, demonstrated by higher levels of fasting insulin and signs of insulin resistance in both HOMA indices and FSIVGTT examinations.

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Metabolic Characteristics and Discriminative Diagnosis of Growth Hormone Deficiency and Idiopathic Short Stature in Preadolescents and Adolescents

Chang,

Chen,

Zhu

et al. 2024

Molecules

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Growth hormone deficiency (GHD) and idiopathic short stature (ISS) are the most common types of short stature (SS), but little is known about their pathogenesis, and even less is known about the study of adolescent SS. In this study, nuclear magnetic resonance (NMR)-based metabolomic analysis combined with least absolute shrinkage and selection operator (LASSO) were performed to identify the biomarkers of different types of SS (including 94 preadolescent GHD (PAG), 61 preadolescent ISS (PAI), 43 adolescent GHD (ADG), and 19 adolescent ISS (ADI)), and the receiver operating characteristic curve (ROC) was further used to evaluate the predictive power of potential biomarkers. The results showed that fourteen, eleven, nine, and fifteen metabolites were identified as the potential biomarkers of PAG, PAI, ADG, and ADI compared with their corresponding controls, respectively. The disturbed metabolic pathways in preadolescent SS were mainly carbohydrate metabolism and lipid metabolism, while disorders of amino acid metabolism played an important role in adolescent SS. The combination of aspartate, ethanolamine, phosphocholine, and trimethylamine was screened out to identify PAI from PAG, and alanine, histidine, isobutyrate, methanol, and phosphocholine gave a high classification accuracy for ADI and ADC. The differences in metabolic characteristics between GHD and ISS in preadolescents and adolescents will contribute to the development of individualized clinical treatments in short stature.

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Metabolic differences between short children with GH peak levels in the lower normal range and healthy children of normal height

Cited by 3 publications

References 45 publications

Growth hormone peak modifies the effect of BMI on increased systolic blood pressure in children with short stature

Growth hormone peak modifies the effect of BMI on increased systolic blood pressure in children with short stature

Metabolic Effects of Growth Hormone Treatment in Short Prepubertal Children: A Double-Blinded Randomized Clinical Trial

Metabolic Characteristics and Discriminative Diagnosis of Growth Hormone Deficiency and Idiopathic Short Stature in Preadolescents and Adolescents

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