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Effects of growth hormone treatment on thyroid function in pediatric patients with Prader-Willi syndrome

Yuji Oto1, Nobuyuki Murakami1, Keiko Matsubara2

  • 1Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.

American Journal of Medical Genetics. Part A
|February 4, 2020
PubMed

Insights

Most pediatric patients with Prader-Willi syndrome (PWS) have normal thyroid function. Growth hormone (GH) treatment did not significantly alter thyroid hormone levels in PWS patients during two years of therapy.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Thyroidology

Background:

  • Prader-Willi syndrome (PWS) is a complex genetic disorder affecting multiple endocrine axes.
  • The presence and management of hypothyroidism in PWS patients remain incompletely understood.
  • Investigating the hypothalamic-pituitary-thyroid (HPT) axis is crucial for comprehensive PWS care.

Purpose of the Study:

  • To assess the status of the HPT axis in pediatric patients with PWS before growth hormone (GH) treatment.
  • To evaluate the impact of GH therapy on thyroid function over a two-year period in these patients.

Main Methods:

  • Retrospective analysis of thyroid function tests in 51 pediatric PWS patients.
  • Utilized thyroid-releasing hormone (TRH) stimulation tests to evaluate HPT axis response.
  • Compared serum levels of free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) at baseline and up to two years post-GH initiation.

Main Results:

  • The majority of PWS patients (49/51) exhibited a normal TSH response to TRH, indicating a functional HPT axis.
  • Only two patients (4.0%) showed patterns suggestive of central hypothyroidism.
  • Thyroid function parameters (TSH, fT4, fT3) remained stable and showed no significant changes during two years of GH treatment.

Conclusions:

  • Pediatric patients with PWS generally do not present with significant hypothyroidism.
  • GH treatment does not appear to adversely affect thyroid function in PWS patients over a two-year period.
  • Routine monitoring of thyroid function may be warranted, but the HPT axis is largely intact in this cohort.

Keywords:
Prader-Willi syndromegrowth hormonehypothyroidismretrospective studies

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