Endocrine Abstracts

Background: A recent RCT of rhGH in IBD over 6 months showed that improvement in linear growth was associated with a reduction in insulin sensitivity.

Objectives: To investigate the effects of prolonged rhGH on growth and glucose homeostasis in children with IBD.

Patients and methods: Eleven children (10CD/1UC) (9 m) with a median age of 14.7 years (range, 8.9, 16.2) who received rhGH (0.067 mg/kg per day) as part a 6-month RCT were studied over a longer period of follow up. Of 11 patients, nine received rhGH for 24 months, 1 for 12 months and 1 for 9 months. Anthropometric data were collected at baseline (T0), 6 months (T6), 12 months (T12) and 24 months (T24) following start of rhGH. Fasting glucose, insulin, c-peptide were also measured.

Results: At T0, the median HtSDS was −2.5 (−3.3, −1.4) compared to a MPHSDS of −0.3 (−1.1, 0.1) (P=0.0001). There was significant improvement in median HtSDS following rhGH at T12 (−1.6 (−2.9,−0.81) P=0.04) and T24 (−1.09 (−2.39, −0.23) P=0.02) compared to T0. The median HV at T0 was 3.3 cm/year and improvement was observed during first 6 months (8.3 cm/year (7, 15) P=0.0004) and T12 (HV=7.2 cm/year (6, 9.7) P=0.0006) in comparison to T0. No significant differences were noticed in BMI and BMI SDS. Similarly no significant alterations were documented in median fasting glucose (mmol/l) level)(at T0 4.7 (3.6,5.5), T6 5 (4.3,5.6), T12 4.9 (4.7,6.7) and T24 4.8 (4.3,6.2)) and median insulin (mU/l) (T0 (5.5 (1.9,11)), T6 (9.5 (2.9,13.3), T12 (9 (4.18,15.8)and T24 (7.8 (3.7,24.2)) during treatment period. Although significant increase in median C peptide level (nmol/l) occurred during first year of treatment (T0 0.5 (0.2, 1.15) vs T12 0.8 (0.4, 1) (P=0.02), it normalised by 2 years (0.6 (0.3, 1.16)).

Conclusion: Our data show that the growth promoting effects of rhGH are maintained over 2 years after therapy without any marked detrimental effect on glucose homeostasis.