ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Paediatric endocrinology (5 abstracts)
Re-evaluation of GH secretion during the transition age in patients with childhood-onset isolated GH deficiency (IGHD) after GH therapy (GHRx)
Sofia Leka-Emiri 1 , Stefanos Stergiotis 1 , Vasilios Petrou 1 , Maria Kafetzi 2 , Petychaki Fotini 1 , Vlachopapadopoulou Elpis-Athina 1 & Stefanos Michalacos 1
1Endocrine Division, P&A Kyriakou Children’S Hospital, Athens, Greece; 2Biochemistry – Hormonology, P&A Kyriakou Children’S Hospital, Athens, Greece.
Objectives: GH in addition to promote linear growth during childhood influences several key metabolic processes as well. In the transition period, from late adolescence to early adulthood, GH plays an important role in skeletal mineralization and muscle mass maturation as well as in developing a favorable cardiometabolic profile. Therefore, several lines of evidence propose GH replacement to be continued if GH evaluation at the transition age fulfills established criteria. The aim of this study was to evaluate GH secretion of patients with childhood-onset isolated GH deficiency (IGHD) at transition age.
Methods: Twenty two patients with childhood-onset IGHD [15 males; age 16.1 years (±1.4)] were re-evaluated for GH secretion (using clonidine or glucagon stimulation test) and a GH peak <5 ng/ml was used for the diagnosis of GHD at the transition phase at least four weeks after discontinuation of therapy.
Results: Seven patients out of twenty two with childhood-onset IGHD [5 males; age 16.5 years (±1.6)] (31.8%) were GHD at retesting. Main characteristics of IGHD patients at diagnosis and IGHD or GH-sufficient (GHS) patients at the end of GHRx are shown in Table 1.
| Characteristics of the patients* | IGHD at diagnosis (n=22) | IGHD in transition (n=7) | GHS in transition (15) |
| Age at diagnosis (years) | 9.6 (2.8) | 8.6 (3.1) | 10.1 (2.6) |
| Sex (M: F) | 15:7 | 5:2 | 10:5 |
| Height (cm) | 127.9 (13.1) | 120.5 (12.3) | 131.5 (13.1) |
| Target height (cm) | 166.6 (6.8) | 167.9 (6.7) | 166.1 (7.1) |
| GH peaks at diagnosis 1st test | 5.79 (2.7) | 6.3 (2.6) | 5.5 (2.8) |
| 2nd test | 5.12 (2.5) | 5.1 (2.3) | 5.1 (2,6) |
| < 5 ng/ml | 1st test: 10 2nd test: 9 | 7 | 0 |
| 5–10 ng/ml | 1st test: 12 2nd test: 13 | 0 | 11 |
| >10 ng/ml | 0 | 4 | |
| Age at the GH re-evaluation (years) | 16.1 (1.4) | 16.5 (1.6) | 15.9 (1.3) |
| GH peak at the end of GHRx (ng/ml) | 7.3 (3.8) | 2.8 (1.4) | 9.3 (2.6) |
| Height at the end of GHRx (cm) | 162.8 (9) | 163.4 (11.7) | 162.5 (8.1) |
| *Values are means ±S.D. | |||
Conclusions: This study demonstrates that one third of childhood - onset IGHD persists during the transition period. Discontinuation of GH therapy may have unfavorable outcome regarding bone density, body composition and lipid profile. Substitution therapy with appropriate adult dosing should be considered.
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Endocrine Abstracts
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