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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Alterations in body composition and fat distribution in growth hormone-deficient prepubertal children during growth
J N Roemmich1, M G Huerta, S M Sundaresan
1Department of Pediatrics, Division of Endocrinology, University of Virginia Health Sciences Center, Charlottesville, VA, USA.
Insights
Growth hormone (GH) therapy in children with GH deficiency accelerates lean tissue accrual, particularly water and protein, and reduces abdominal visceral fat within months. It has a lesser impact on overall fat mass reduction.
Area of Science:
- Pediatric Endocrinology
- Body Composition Analysis
- Metabolic Health
Background:
- Growth hormone (GH) deficiency in children leads to adverse body composition, including increased body fat and reduced lean mass, potentially increasing later health risks.
- The precise in vivo effects of GH on body composition and fat distribution in children have not been fully elucidated.
- Understanding these effects is crucial for managing long-term health outcomes in GH-deficient children.
Purpose of the Study:
- To investigate the impact of GH therapy on body composition, fat distribution, and the proportional composition of fat-free mass (FFM) in GH-deficient prepubertal children.
- To compare these effects with those observed in healthy control children.
- To assess the short-term (1-3 months) and longer-term effects of GH replacement therapy.
Main Methods:
- A 4-compartment model was used to assess body composition in GH-deficient children receiving GH therapy (n=6) and healthy control children (n=6).
- Magnetic resonance imaging (MRI) was employed to measure abdominal visceral and subcutaneous fat.
- Skinfold thickness measurements were also taken at abdominal and suprailiac sites.
Main Results:
- GH therapy significantly reduced percent body fat within the first 3 months, primarily due to an increase in FFM, which accounted for most of the weight gain.
- Fat mass remained unchanged in GH-deficient children but increased in controls; FFM increased threefold more in the GH-deficient group.
- MRI revealed a reduction in abdominal visceral fat with GH therapy, while subcutaneous fat and skinfold thicknesses showed no significant changes.
Conclusions:
- GH therapy rapidly accelerates lean tissue accrual, including water and protein components, in GH-deficient children.
- The therapy demonstrates site-specific efficacy in reducing abdominal visceral adiposity.
- GH replacement therapy shows a notable, albeit temporary, impact on body composition and fat distribution within the initial treatment period.
Abstract:
Growth hormone (GH) deficiency in children results in increased body fat, reduced fat-free mass (FFM) including muscle (protein) and bone, and abdominal obesity. Thus, proper GH secretion likely has major developmental influences on later health risks including cardiovascular diseases and osteoporosis. However, the in vivo control of the development of the body composition and fat distribution by GH has not yet been accurately investigated using children with GH deficiency as a model. We determined the effect of GH therapy (GH replacement, n = 3; GH + physiologic cortisol and thyroxine replacement, n = 3) on body composition, the proportional composition of the FFM, and body fat distribution in GH-deficient prepubertal children compared with healthy control children (n = 6) not treated with GH. The GH-deficient and control children were initially matched for gender, bone age, and weight. As assessed by a 4-compartment model, GH therapy reduced percent body fat during the first 3 months of therapy but not thereafter. This change was primarily due to FFM, which increased 3-fold more in the GH-deficient group and accounted for 91.5% of the increase in body weight. Fat mass increased in the controls but was unchanged in the GH-deficient group. Therapy temporarily increased the proportional contribution of water to the FFM, decreased the proportion of mineral, and slightly increased the proportion of protein. Using magnetic resonance imaging (MRI), abdominal visceral fat was reduced in the GH-deficient group and unchanged in the controls. Abdominal subcutaneous fat measured in the same image was not changed. The abdominal and suprailiac skinfold thicknesses also were not decreased in the GH-deficient group. In conclusion, within 1 to 3 months, GH therapy accelerates lean tissue accrual, especially the water and protein components, but has a smaller effect on reducing fat mass. GH therapy has site-specific effects on reducing abdominal adiposity.
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