Related Experiment Videos
Effects of growth hormone and nutritional therapy in boys with constitutional growth delay: a randomized controlled
Joan C Han1, Ligeia Damaso, Susan Welch
1Division of Endocrinology, Nemours Children's Clinic, Jacksonville, FL 32207, USA.
Insights
Nutritional supplementation did not enhance growth hormone therapy in boys with delayed growth. Growth hormone treatment improved growth similarly in boys with constitutional delay of growth and maturation, regardless of added nutrition.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Nutritional Science
Background:
- Constitutional delay of growth and maturation (CDGM) is a common cause of short stature in children.
- Growth hormone (GH) therapy is used to treat various growth disorders.
- The role of nutritional supplementation in augmenting GH therapy for CDGM requires further investigation.
Purpose of the Study:
- To determine if nutritional supplementation enhances the anabolic effects of growth hormone (GH) in boys with CDGM.
- To assess the impact of combined GH and nutritional therapy on growth parameters and metabolic markers.
Main Methods:
- A randomized controlled trial involving 20 prepubertal boys with CDGM.
- Participants were randomized to 6 months of observation or nutritional supplementation.
- All participants received GH therapy for a subsequent 12 months, with comparisons of energy intake, expenditure, and growth markers.
Main Results:
- Nutritional supplementation increased energy intake but did not significantly alter total energy expenditure at 6 months.
- GH therapy increased energy intake and expenditure in the combined GH/nutrition group at 12 months.
- Height, weight, lean body mass, and hormonal/nutritional markers improved similarly in both groups over 18 months.
Conclusions:
- Boys with CDGM exhibit an accelerated energy expenditure that is not improved by nutritional supplementation alone.
- Growth hormone therapy promotes comparable growth in boys with CDGM, irrespective of concurrent nutritional support.
Objective:
To examine whether supplemental nutrition augments the anabolic actions of growth hormone (GH) in boys with constitutional delay of growth and maturation (CDGM).
Study Design:
We conducted a randomized, controlled trial at an outpatient clinical research center. Subjects were 20 prepubertal boys (age, 9.3 ± 1.3 years) with CDGM (height standard deviation score, -2.0 ± 0.5; bone age delay, 1.8 ± 0.8 years; body mass index standard deviation score, -1.2 ± 1.0; peak stimulated GH, 15.7 ± 7.7 ng/mL), who were randomized (n = 10/group) to 6 months observation or daily nutritional supplementation, followed by additional daily GH therapy in all for another 12 months. t tests and repeated measures analyses of variance compared energy intake, total energy expenditure (TEE), growth, hormones, and nutrition markers.
Results:
Energy intake was increased at 6 months within the nutrition group (P = .04), but not the observation group, and TEE was not statistically different within either group at 6 months. Addition of 6 months GH resulted in higher energy intake and TEE in the GH/nutrition group at 12 months (P < .01), but not in the GH group versus baseline. Height, weight, lean body mass, hormones, and nutrition markers increased comparably in both groups throughout 18 months.
Conclusion:
Boys with CDGM use energy at an accelerated rate, an imbalance not overcome with added nutrition. GH therapy increases growth comparably with or without added nutrition in these patients.
Related Concept Videos
Nature and Nurture
Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Signs of Puberty
Role of Hematopoietic Growth Factors
Thrombopoietin (TPO), mainly released by the liver,...
Cellular Adaptation II: Hypertrophy
Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...