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Linear growth, growth-hormone secretion and IGF-I generation in children with neglected hypothyroidism before and

Ashraf T Soliman1, Magdy Omar, Ahmad El Awwa

  • 1Department of Pediatrics, University of Alexandria Children's Hospital, El Chatby, Alexandria, Egypt. ATSOLIMAN@yahoo.com

Journal of Tropical Pediatrics
|May 3, 2008
PubMed

Insights

Thyroxine (T4) replacement therapy in children with congenital hypothyroidism (CH) significantly improved height and the growth hormone (GH)-insulin-like growth factor-I (IGF-I) axis, indicating partial catch-up growth.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Disorders
  • Congenital Hypothyroidism

Background:

  • Congenital hypothyroidism (CH) can impair growth and the growth hormone (GH)-insulin-like growth factor-I (IGF-I) axis.
  • Long-term effects of neglected CH on growth and endocrine function require further investigation.

Purpose of the Study:

  • To evaluate the impact of thyroxine (T4) replacement on growth parameters and the GH-IGF-I axis in children with neglected CH.
  • To assess the recovery of GH and IGF-I generation after T4 treatment.

Main Methods:

  • Studied 15 children with neglected CH (mean age 6.4 years).
  • Measured growth parameters, GH stimulation (clonidine), and IGF-I generation tests before and after >1 year of T4 replacement.
  • Analyzed correlations between height SDS increments and basal free T4 levels.

Main Results:

  • Height SDS improved significantly from -4.3 to -2.7 after one year of T4 treatment.
  • Peak GH response to clonidine increased from 3.2 to 7.62 ng/mL.
  • Basal and peak IGF-I levels showed substantial increases, indicating improved GH-IGF-I axis function. Height SDS increments correlated with basal free T4.

Conclusions:

  • T4 replacement therapy in children with neglected CH promotes significant catch-up growth.
  • Treatment partially restores the GH-IGF-I axis function, underscoring the importance of early diagnosis and management.
  • The degree of catch-up growth is linked to basal free T4 concentrations during treatment.

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