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Idiopathic short stature and growth hormone sensitivity in prepubertal children

José G B Derraik1,2,3, Harriet L Miles1, Valentina Chiavaroli1

  • 1Liggins Institute, University of Auckland, Auckland, New Zealand.

Clinical Endocrinology
|March 26, 2019
PubMed

Insights

Children with idiopathic short stature (ISS) show reduced growth hormone sensitivity, especially those with lower birth weights. This may indicate partial growth hormone resistance contributing to their short stature.

Area of Science:

  • Pediatric Endocrinology
  • Growth Hormone Therapy
  • Metabolic Research

Background:

  • Idiopathic short stature (ISS) affects children with no identifiable cause for their short stature.
  • Birth weight and its relation to growth hormone (GH) sensitivity are crucial in understanding pediatric growth disorders.
  • Insulin-like growth factor I (IGF-I) is a key mediator of GH action.

Purpose of the Study:

  • To compare GH sensitivity using an IGF-I generation test in children with ISS and normal stature (NS).
  • To investigate the association between birth weight and GH sensitivity in children.
  • To explore hormonal responses to recombinant human growth hormone (rhGH) in different birth weight categories.

Main Methods:

  • Forty-six prepubertal children (ISS n=23, NS n=23) born at term were studied.
  • A modified IGF-I generation test using rhGH (0.05 mg/kg/d) over four days was administered.
  • Hormonal concentrations (IGF-I, GHBP, leptin, IGFBP-1, insulin) were measured at baseline and day 5.

Main Results:

  • Children with ISS were lighter and had higher body fat compared to NS children.
  • Decreasing birth weight standard deviation score (SDS) correlated with lower IGF-I response to rhGH stimulation.
  • GH binding protein (GHBP) levels were suppressed in ISS children but increased in NS children, with contrasting responses in leptin and IGFBP-1. Insulin response to rhGH was significantly higher in NS children.

Conclusions:

  • Reduced birth weight is associated with decreased GH sensitivity in both NS and ISS children.
  • ISS children with lower birth weights may exhibit partial GH resistance, contributing to poorer growth.
  • The study highlights the impact of birth weight on GH action and its implications for short stature.
Abstract

Keywords:
growth hormone binding globulinheightinsulin-like growth factor Irecombinant human growth hormonesensitivity

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