Metabolic effects of growth hormone in the child and adolescent

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Growth Hormone Therapy

Background:

• Growth hormone (GH) therapy is used for various pediatric conditions.
• Understanding its metabolic effects and safety profile is crucial for clinical practice.
• Previous studies have indicated potential benefits and risks associated with GH treatment.

Purpose of the Study:

• To review and synthesize original studies published in 2000 on the metabolic effects of GH therapy in pediatric patients.
• To assess the impact of GH on glucose metabolism, bone health, body composition, skin properties, and safety outcomes (tumors, transplantation).

Main Methods:

• Systematic review and synthesis of original research studies published in the year 2000.
• Analysis of data from the Pharmacia International Growth Study database.
• Inclusion of studies focusing on pediatric patients with conditions like intrauterine growth retardation, Turner syndrome, chronic renal failure, Prader-Willi syndrome, and brain tumors.

Main Results:

• GH therapy rarely caused glucose tolerance abnormalities but increased insulin levels in some groups.
• GH increased bone turnover markers and bone mineral density in children with chronic renal failure and Prader-Willi syndrome.
• GH reduced body fat, improved physical skills, and increased lean mass in Prader-Willi syndrome; leptin levels decreased dose-dependently in intrauterine growth retardation.
• GH improved skin thickness and reduced stiffness in GH-deficient children.
• No increased risk of tumor recurrence or mortality was observed in brain tumor patients.
• GH did not adversely affect graft survival or rejection episodes in children awaiting kidney transplantation.

Conclusions:

• Growth hormone therapy offers significant metabolic and physical benefits in various pediatric conditions.
• Continued surveillance for type 2 diabetes is warranted in GH-treated patients.
• GH therapy appears safe concerning tumor recurrence and kidney transplant outcomes in pediatric populations.