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Prevalence of growth hormone deficiency in children with cleft lip or palate
Insights
Children with cleft lip and palate (CLP) have significantly higher rates of short stature and growth hormone (GH) deficiency. This suggests a potential link between CLP embryology and endocrine development.
Area of Science:
- Pediatric Endocrinology
- Craniofacial Anomalies
- Growth Disorders
Background:
- Short stature affects 12% of children with isolated cleft lip/palate (CLP).
- Endocrine evaluation is crucial for short children with CLP.
Purpose of the Study:
- To investigate the prevalence of growth hormone (GH) deficiency in short children with isolated CLP.
- To compare GH deficiency rates in children with and without CLP.
Main Methods:
- Surveyed stature in 200 children (7-14 years) with isolated CLP.
- Assessed endogenous GH after stilbesterol pretreatment.
- Evaluated 75 short children without CLP as a control group.
Main Results:
- Four of 25 short CLP children had total GH deficiency; four had partial GH deficiency.
- Three GH-deficient CLP patients also had ACTH or TSH deficiency.
- Short children with CLP had 4x higher short stature and 40x higher GH deficiency rates than controls.
Conclusions:
- Children with isolated CLP exhibit significantly higher incidences of short stature and GH deficiency.
- Embryologic origins of CLP may be linked to adenohypophysis development, potentially causing GH deficiency.
Abstract:
Two hundred children 7 to 14 years of age with isolated cleft defects of the lip, palate, or both were surveyed for stature. Twelve percent were less than the third percentile in height and were designated "short." All of the short children received an endocrine evaluation. Endogenous growth hormone was examined after two days' pretreatment with stilbesteral. Four of the 25 short children with CLP had total, and four had partial, GH deficiency. Three of the GH-deficient patients were also deficient in ACTH or TSH. In contrast, in a series of 75 short (less than third percentile) children 7 to 14 years of age without cleft defect or other apparent congenital abnormality, only two had total and two had partial GH deficiency. The data suggest that children with isolated CLP have short stature about four times more often, and GH-deficiency about 40 times more often, than children without CLP. The increased prevalence of GH-deficiency may stem from the embryologic relation of adenohypophysis and oral ectoderm.