BSPED2009 Poster Presentations (1) (38 abstracts)
Reduced growth hormone secretion in children and young adults following total body irradiation (TBI) for bone marrow transplantation (BMT) in childhood
Nikki Davis 1 , Ruth Elson 1 , Claire Stewart 2 , Andrew Moss 2 , Wolf Woltersdorf 1 , Jacqueline Cornish 1 , Michael Stevens 1 & Elizabeth Crowne 1
1Bristol Royal Hospital for Children, Bristol, UK; 2Manchester Metropolitan University, Manchester, UK.
Introduction: Growth hormone deficiency (GHD) after cranial irradiation (CRI) is time, dose and fraction dependent. TBI (12–14.4Gy) involves low dose CRI, and skeletal irradiation causing further adverse growth effects. We present baseline data from a prospective study of GH treatment.
Subjects N=25: We studied 13 BMT survivors (all had TBI, 3 also had CRI <18Gy), and 12 non-BMT subjects investigated for GHD. Both groups contained young GH-naïve children and young adults having end of GH-treatment retests and were well-matched for age, gender and pubertal status.
Methods: GH treatment was stopped >3 months before study if applicable.12 hr overnight GH profiles (GHP) were performed (20 min sampling 9pm–9am) and analysed by Cluster and Autodeconvolution software. Subjects slept at their usual time. 22 subjects also had an insulin tolerance test (ITT). Body composition was measured by DEXA.
Results: Median(range) age at and time since BMT were 5.8 (0.2–16.0) yrs and 3.5 (1.2–19.3) yrs respectively. Compared to controls, BMT survivors had increased % body fat (35.5(10.3) vs 25.5(12.8), P<0.05) and reduced peak GH levels in ITT (4.3(3.0) vs 7.7(5.0) μg/l, P<0.05) and their GHPs demonstrated reduced peak (3.5(1.5) vs 6.3(3.2) μg/l, P<0.05) and area under the curve (AUC) (7.0(3.4) vs 15.9(11.9) μg/l/min, P<0.05). Peak and AUC in GHP correlated with % body fat (r=−0.45, P<0.05 and r=−0.55, P<0.005). Covariate analysis showed that BMT had an additional effect on peak GH and AUC after adjusting for body fat, and that CRI had an additional effect to TBI. There was no gender effect. 7/8 adult BMT survivors were GH insufficient on retesting.
Discussion: These data indicate a significant reduction in GH secretion after BMT partly explained by increased adiposity. Additional TBI effects relate to hypothalamic-pituitary exposure and potentially altered feedback following skeletal irradiation. GHD was more pronounced in adult TBI survivors.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more