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Growth hormone treatment in young children with Down's syndrome: effects on growth and psychomotor development
G Annerén1, T Tuvemo, C Carlsson-Skwirut
1Department of Genetics and Pathology, Unit of Clinical Genetics, Uppsala University Children's Hospital, S-751 85 Uppsala, Sweden. goran.anneren@ped.uas.lul.se
Insights
Growth hormone (GH) treatment improved linear growth in children with Down syndrome, but did not impact cognitive or motor development. Growth velocity decreased after treatment cessation.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Down syndrome is characterized by learning disabilities and short stature.
- Insulin-like Growth Factor I (IGF-I), regulated by Growth Hormone (GH), may play a role in brain development.
Purpose of the Study:
- To investigate the long-term effects of GH on linear growth and psychomotor development in young children with Down syndrome.
- To assess the impact of GH on skeletal maturation, IGF-I, IGF binding proteins (BP), and cerebrospinal fluid (CSF) IGF-II.
Main Methods:
- A three-year study involving 15 children with Down syndrome (ages 6-9 months).
- Treatment with GH was administered, with regular monitoring of growth parameters, psychomotor development, and biochemical markers.
- A control group of children with Down syndrome was used for comparison.
Main Results:
- GH treatment increased mean height SDS from -1.8 to -0.8, while the control group's height fell from -1.7 to -2.2 SDS.
- Growth velocity decreased after GH treatment cessation.
- No significant improvements were observed in head circumference, mental development, or gross motor skills.
- Serum IGF-I and IGFBP-3 levels normalized during GH treatment.
Conclusions:
- GH treatment effectively improves linear growth velocity in children with Down syndrome.
- GH therapy does not influence head circumference, cognitive function, or gross motor development in this population.
- The positive effects on growth velocity are not sustained after treatment discontinuation.
Background:
Learning disability and short stature are cardinal signs of Down's syndrome. Insulin-like growth factor I (IGF-I), regulated by growth hormone (GH) from about 6 months of age, may be involved in brain development.
Aims:
To study long term effects of GH on linear growth and psychomotor development in young children with Down's syndrome. Study design-Fifteen children with Down's syndrome were treated with GH for three years from the age of 6 to 9 months (mean, 7.4). Linear growth, psychomotor development, skeletal maturation, serum concentrations of IGF-I and its binding proteins (BPs), and cerebrospinal fluid (CSF) concentrations of IGF-II were studied.
Results:
The mean height of the study group increased from -1.8 to -0.8 SDS (Swedish standard) during treatment, whereas that of a Down's syndrome control group fell from -1.7 to -2.2 SDS. Growth velocity declined after treatment stopped. Head growth did not accelerate during treatment. No significant difference in mental or gross motor development was found. The low concentrations of serum IGF-I and IGFBP-3 became normal during GH treatment.
Conclusions:
GH treatment results in normal growth velocity in Down's syndrome but does not affect head circumference or mental or gross motor development. Growth velocity declines after treatment stops.