2015
DOI: 10.1007/s40618-015-0314-7
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Revaluation of the clinical and metabolic behavior of children with isolated growth hormone deficiency during GH treatment according to newly proposed note 39 of the Italian Medicines Agency (AIFA)

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Cited by 16 publications
(19 citation statements)
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“…Indeed, it is widely known that GHT leads to a decrease in insulin sensitivity and alteration in insulin secretion even without overt changes in glucose tolerance, and the current study confirms this finding, as demonstrated by the unchanged HbA1c levels. In addition, a slight improvement in lipid profile was demonstrated after 12 months of GHT and this finding is in agreement with our previous studies [15,40]. Overall, in our opinion, the metabolic changes which occur after GHT are likely secondary to the counter-regulating effects of GH (the increase in glucose and insulin levels and the reduction in insulin sensitivity) and to its lipolytic effect (demonstrated by the improvement in lipid profile and reduction in WC).…”
Section: Discussionsupporting
confidence: 92%
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“…Indeed, it is widely known that GHT leads to a decrease in insulin sensitivity and alteration in insulin secretion even without overt changes in glucose tolerance, and the current study confirms this finding, as demonstrated by the unchanged HbA1c levels. In addition, a slight improvement in lipid profile was demonstrated after 12 months of GHT and this finding is in agreement with our previous studies [15,40]. Overall, in our opinion, the metabolic changes which occur after GHT are likely secondary to the counter-regulating effects of GH (the increase in glucose and insulin levels and the reduction in insulin sensitivity) and to its lipolytic effect (demonstrated by the improvement in lipid profile and reduction in WC).…”
Section: Discussionsupporting
confidence: 92%
“…As radiological criteria we considered a bone age delay, estimated from an X-ray of the left wrist and hand and evaluated according to the methods of Greulich and Pyle, of at least 1 year with respect to the chronological age [14]. Biochemically, GHD was diagnosed by the failure of GH to respond to glucagon stimulation test (GST) and insulin tolerance test (ITT), with GH peaks below 8 µg/l [15]. Neuroimaging, with magnetic resonance of the hypothalamic-pituitary region, was performed in all children with more severe GHD, i.e., with GH peak ≤3 μg/l, and when we suspected there was a multiple pituitary deficiency (overall in 11 children).…”
Section: Methodsmentioning
confidence: 99%
“…Indeed, given the insulin antagonistic action of GH in addition to the direct stimulatory effect on β -cell, GHT can lead to glucose metabolism impairment through a decrease in insulin sensitivity and an impairment of pancreatic β -cell function [35]. We previously demonstrated an increase in Homa-IR, related to the increased insulin levels, in GHD children after GHT [36, 37], and a degree of impairment of glucose metabolism during GHT has often been previously demonstrated [38]. However, the limit of the evaluation of the insulin sensitivity and secretion performed through insulin-derived indexes [39] is always to be taken into account.…”
Section: Discussionmentioning
confidence: 99%
“…Several studies have demonstrated that GH, apart from promoting lineal growth, plays a key role in various metabolic processes .…”
Section: Discussionmentioning
confidence: 99%
“…Growth hormone replacement therapy in GHD children benefits lipid metabolism, and many studies have noted that it decreases total cholesterol, LDL cholesterol and triglycerides and causes a moderate increase in HDL cholesterol after at least one year of replacement therapy . However, other authors have not reported any effect on children’s lipid metabolisms .…”
Section: Introductionmentioning
confidence: 99%