Effect of corticoid therapy on growth hormone secretion

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M Bozzola1, F Locatelli, D Gambarana

  • 1Pediatric Clinic, University of Pavia, IRCCS Policlinico San Matteo, Italy.

Hormone Research
|January 1, 1991
PubMed

Insights

Corticosteroid treatment in children with leukemia suppresses growth hormone (GH) release. GH secretion partially recovers after stopping steroids, but insulin-like growth factor 1 levels remain low, indicating potential long-term growth impairment.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Oncology

Background:

  • Exogenous corticosteroids are known to inhibit linear growth in children.
  • Children with acute lymphoblastic leukemia often receive corticosteroid therapy as part of their treatment.

Purpose of the Study:

  • To investigate the mechanisms of growth failure during corticosteroid treatment in children with acute lymphoblastic leukemia.
  • To evaluate the impact of high-dose prednisone on growth hormone (GH) secretion and recovery after drug withdrawal.

Main Methods:

  • Short-term high-dose prednisone treatment was administered to 7 prepubertal children with acute lymphoblastic leukemia.
  • Growth hormone (GH) release was assessed during sleep and in response to arginine, insulin, and GH-releasing hormone (GHRH) before, during, and after steroid treatment.
  • Insulin-like growth factor 1 (IGF-1) levels were also measured.

Main Results:

  • Corticosteroid therapy significantly suppressed GH secretion during sleep and in response to stimuli.
  • GH responsiveness partially recovered after steroid discontinuation, particularly to GHRH and arginine.
  • Insulin-like growth factor 1 (IGF-1) levels remained low even after steroid withdrawal, suggesting persistent growth impairment.

Conclusions:

  • High-dose corticosteroid treatment impairs GH secretion in children with acute lymphoblastic leukemia.
  • While GH secretion shows partial recovery after steroid withdrawal, sustained low IGF-1 levels indicate potential for long-term growth failure.
  • The adrenergic response to insulin may not immediately recover following corticosteroid discontinuation.

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