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Metabolic effects of growth hormone (GH) replacement in children and adolescents with severe isolated GH deficiency due to a GHRH receptor mutation.
Clin Endocrinol (Oxf). 2007 Apr; 66(4):466-74.CE

Abstract

BACKGROUND

The interpretation of the true effect of GH replacement therapy (GHRT) on metabolic status in GH deficiency (GHD) is often complicated by differing aetiologies of GHD and by the presence of additional hormone deficits.

OBJECTIVE

To study the growth and response of the lipid profile and body composition to GHRT in a cohort of children with the same mutation in the GHRH receptor gene. Design Nine GH-deficient subjects (mean age 12.8 years, range 5-17.5 years; three male) in a rural community in Northeast Brazil were treated with GHRT for 2 years and compared with indigenous normal controls.

MAIN OUTCOME MEASURES

Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and body composition were measured at baseline and after 3, 12 and 24 months of GHRT.

RESULTS

At baseline, the subjects with GHD had an adverse lipid profile, including elevated TC, elevated LDL-C and elevated TG. GHRT normalized TG in 3 months, LDL-C in 12 months and TC in 24 months. At baseline, older pubertal subjects with GHD had adverse body composition, including higher percentage fat mass (%FM), and GHRT induced a reduction in %FM that was maintained after 24 months. By contrast, younger prepubertal subjects did not have an adverse body composition.

CONCLUSIONS

Lipid profile was abnormal at baseline, while abnormal body composition was only seen in older subjects in late puberty, indicating that body composition is less sensitive to the effect of GHD than lipid profile. GHRT improves lipid profile at all ages, while it affects body composition only towards the end of growth, emphasizing its importance in achieving normal somatic development in the transition period.

Authors+Show Affiliations

Christie Hospital, Department of Endocrinology, Manchester, UK. helena@kgleeson99.freeserve.co.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17371461

Citation

Gleeson, Helena, et al. "Metabolic Effects of Growth Hormone (GH) Replacement in Children and Adolescents With Severe Isolated GH Deficiency Due to a GHRH Receptor Mutation." Clinical Endocrinology, vol. 66, no. 4, 2007, pp. 466-74.
Gleeson H, Barreto ES, Salvatori R, et al. Metabolic effects of growth hormone (GH) replacement in children and adolescents with severe isolated GH deficiency due to a GHRH receptor mutation. Clin Endocrinol (Oxf). 2007;66(4):466-74.
Gleeson, H., Barreto, E. S., Salvatori, R., Costa, L., Oliveira, C. R., Pereira, R. M., Clayton, P., & Aguiar-Oliveira, M. H. (2007). Metabolic effects of growth hormone (GH) replacement in children and adolescents with severe isolated GH deficiency due to a GHRH receptor mutation. Clinical Endocrinology, 66(4), 466-74.
Gleeson H, et al. Metabolic Effects of Growth Hormone (GH) Replacement in Children and Adolescents With Severe Isolated GH Deficiency Due to a GHRH Receptor Mutation. Clin Endocrinol (Oxf). 2007;66(4):466-74. PubMed PMID: 17371461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic effects of growth hormone (GH) replacement in children and adolescents with severe isolated GH deficiency due to a GHRH receptor mutation. AU - Gleeson,Helena, AU - Barreto,Elenilde S de A, AU - Salvatori,Roberto, AU - Costa,Liana, AU - Oliveira,Carla R P, AU - Pereira,Rossana M C, AU - Clayton,Peter, AU - Aguiar-Oliveira,Manuel H, PY - 2007/3/21/pubmed PY - 2007/9/19/medline PY - 2007/3/21/entrez SP - 466 EP - 74 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 66 IS - 4 N2 - BACKGROUND: The interpretation of the true effect of GH replacement therapy (GHRT) on metabolic status in GH deficiency (GHD) is often complicated by differing aetiologies of GHD and by the presence of additional hormone deficits. OBJECTIVE: To study the growth and response of the lipid profile and body composition to GHRT in a cohort of children with the same mutation in the GHRH receptor gene. Design Nine GH-deficient subjects (mean age 12.8 years, range 5-17.5 years; three male) in a rural community in Northeast Brazil were treated with GHRT for 2 years and compared with indigenous normal controls. MAIN OUTCOME MEASURES: Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and body composition were measured at baseline and after 3, 12 and 24 months of GHRT. RESULTS: At baseline, the subjects with GHD had an adverse lipid profile, including elevated TC, elevated LDL-C and elevated TG. GHRT normalized TG in 3 months, LDL-C in 12 months and TC in 24 months. At baseline, older pubertal subjects with GHD had adverse body composition, including higher percentage fat mass (%FM), and GHRT induced a reduction in %FM that was maintained after 24 months. By contrast, younger prepubertal subjects did not have an adverse body composition. CONCLUSIONS: Lipid profile was abnormal at baseline, while abnormal body composition was only seen in older subjects in late puberty, indicating that body composition is less sensitive to the effect of GHD than lipid profile. GHRT improves lipid profile at all ages, while it affects body composition only towards the end of growth, emphasizing its importance in achieving normal somatic development in the transition period. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/17371461/Metabolic_effects_of_growth_hormone__GH__replacement_in_children_and_adolescents_with_severe_isolated_GH_deficiency_due_to_a_GHRH_receptor_mutation_ L2 - https://doi.org/10.1111/j.1365-2265.2007.02753.x DB - PRIME DP - Unbound Medicine ER -