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Puberty, statural growth, and growth hormone release in children with cerebral palsy

Michelle N Kuperminc1, Matthew J Gurka, Christine M Houlihan

  • 1Department of Pediatrics, University of Virginia.

Journal of Pediatric Rehabilitation Medicine
|March 11, 2010
PubMed

Insights

Children with cerebral palsy (CP) exhibit slower growth than typically developing peers. Lower levels of insulin-like growth factor 1 (IGF-1) and growth hormone (GH) may contribute to this growth difference in children with CP.

Area of Science:

  • Pediatric Endocrinology
  • Growth and Development
  • Neurology

Background:

  • Children with cerebral palsy (CP) often present with growth deficits compared to typically developing children.
  • The role of the growth hormone (GH) axis in pubertal growth among children with CP remains under-investigated.

Purpose of the Study:

  • To compare growth patterns and GH axis markers in pre-pubertal and pubertal children with moderate to severe CP against a control group over three years.
  • To elucidate the association between the GH axis and growth in children with CP during puberty.

Main Methods:

  • A longitudinal study comparing 20 children with CP (Gross Motor Function Classification System levels III-V, ages 6-18) to 63 typically growing children.
  • Data collection included anthropometry, Tanner stage, bone age, and laboratory analyses (spontaneous overnight GH release, fasting IGF-1, IGFBP-3) every six months for three years.
  • Statistical analysis utilized repeated measures models, accounting for gender, age, and nutritional status to assess interactions between Tanner stage and group.

Main Results:

  • Children with CP demonstrated significantly slower growth across all Tanner stages compared to the reference group (p<0.01).
  • While patterns of GH and IGF-1 secretion were similar, girls with CP had lower concentrations of IGF-1 (p<0.01) and GH (p<0.01).
  • A similar, though not statistically significant, trend of lower IGF-1 and GH was observed in boys with CP.

Conclusions:

  • Reduced circulating concentrations of IGF-1 and GH are potential contributors to the observed growth differences in children with CP.
  • These findings highlight the importance of monitoring the GH axis in children with CP to understand and potentially address growth impairments.
Abstract

Keywords:
cerebral palsygrowthgrowth hormonestature

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