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[Thyroid and thyrotropin functions in subjects with pituitary nanism treated with growth hormone]
G Saggese1, G Cesaretti, G Di Spigno
1Clinica Pediatrica I, Università di Pisa, Italia.
Insights
Growth Hormone (GH) treatment in children with GH deficiency did not significantly alter thyroid function. Minor, transient changes in TSH response to TRH were observed but did not impact growth outcomes.
Area of Science:
- Pediatric Endocrinology
- Thyroid Function
- Growth Hormone Therapy
Context:
- Children with classic Growth Hormone (GH) deficiency require long-term treatment.
- Thyroid function is crucial for normal growth and development.
- Monitoring endocrine function during GH therapy is essential.
Purpose:
- To evaluate thyroid and thyrotropin function during long-term GH treatment in children with GH deficiency.
- To assess the impact of GH therapy on the hypothalamic-pituitary-thyroid axis.
- To determine if changes in thyrotropin response affect growth velocity.
Summary:
- Thyroid hormone levels (thyroxine) and basal thyroid-stimulating hormone (TSH) remained within normal limits in 21 children during 2-6 years of GH treatment.
- A delayed and higher TSH peak after thyreotropin-releasing hormone (TRH) administration was observed in a small subset of children at various time points.
- These transient TSH response alterations did not correlate with diminished growth response to GH therapy, indicating preserved growth velocity.
Impact:
- GH therapy appears safe concerning thyroid function in children with GH deficiency.
- Transient TSH response changes during GH treatment do not negatively impact growth.
- This study provides evidence for the continued efficacy of GH treatment irrespective of minor thyroid axis fluctuations.
Abstract:
We have evaluated thyroid and thyrotropin functions before the beginning and during Growth Hormone (GH) treatment for a 2-6-year period in a group composed of 21 children (age: 6.6 +/- 1.1 years, m +/- SD) suffering from classic GH deficiency. Circulating levels of thyroxine, and basal thyroid-stimulating hormone (TSH) always resulted in the normal range. TSH response to thyreotropin-releasing hormone administration showed in some subjects (one out of 21 before the start of treatment, 2 out of 16 after 2 years, 3 out of 12 after 4 years and 2 out of 10 after 6 years) a delayed (after 90-120 minutes) and higher peak in comparison to that of normal subjects. All these high and delayed values have been showed in only one occasion by different children, with the exception of a child who has presented the higher values in two occasions. Growth response to GH treatment has not been modified by the change in thyrotropin response, as subjects with high TSH peak have had a height velocity similar to that of the other children in the corresponding periods of study.