Evaluation of Growth Hormone Deficiency in Children with Cystic Fibrosis
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Published on: April 11, 2018
Mohsen Reisi1, Niloufar Sharif Ahmadian2, Mahin Hashemipour3
1Department of Pediatrics, Faculty of Medicine, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Growth hormone deficiency (GHD) affects 6.6% of children with cystic fibrosis (CF), a higher prevalence than in the general pediatric population. Further research is needed to understand the causes of GHD in CF patients.
Area of Science:
- Pediatric Endocrinology
- Genetics and Genetic Diseases
- Pulmonology
Background:
- Cystic Fibrosis (CF) is associated with chronic respiratory and gastrointestinal issues, frequently leading to growth failure in affected children.
- Growth hormone deficiency (GHD) is a potential contributor to growth impairment in pediatric CF patients.
Purpose of the Study:
- To determine the prevalence of GHD in children with CF presenting with stable gastrointestinal and respiratory conditions.
- To compare GHD prevalence in CF children with a control group of children experiencing growth failure.
Main Methods:
- A 3-year longitudinal study monitored growth indicators in 150 children (4-16 years) with CF.
- Children with growth failure (<3% weight percentile or significant height deceleration) and stable CF underwent clonidine and L-dopa GH stimulation tests.
- A control group of children without CF but with growth failure was included for comparative analysis.
Main Results:
- Growth failure was observed in 24 CF patients (16%) with stable conditions.
- GHD was diagnosed in 10 of these CF patients, resulting in a GHD prevalence of 6.6% in the CF cohort.
- The prevalence of GHD in the control group (9 out of 30) was not significantly different from the CF group (P = 0.37).
Conclusions:
- The prevalence of GHD in children with CF is 6.6%, significantly higher than the <1% observed in the general pediatric population.
- The findings suggest a potential link between CF and GHD that warrants further investigation.
- Additional research is recommended to elucidate the underlying mechanisms causing GHD in CF patients.
Background:
Due to chronic respiratory and gastrointestinal problems, growth failure is a common issue in patients with cystic fibrosis (CF). The present study aimed to investigate the prevalence of growth hormone deficiency (GHD) in CF children with stable gastrointestinal and respiratory conditions.
Materials And Methods:
In this study, the growth indicators of all 4-16-year-old children referred to two CF clinics were monitored over 3 years. Children without severe gastrointestinal or pulmonary symptoms with weight <3% percentile or whose height increase were two standard deviations below their expected height growth over 6 months were selected for the growth hormone (GH) stimulation test by clonidine and L-dopa test. Some of the children without CF, who were also referred for height growth disorders and matched the CF group, were considered the control group. They underwent the GH stimulation test, and the results were compared.
Results:
From 150 patients with CF, growth failure was observed in 24 patients with stable gastrointestinal and respiratory conditions; in 10 of them, the GH stimulation test was deficient. The prevalence of GHD was 6.6% in CF patients. In the control group of 30 children without CF, but with growth failure, the GH was deficient in nine cases, implying no significant difference with the case group (P = 0.37).
Conclusion:
In our study, the prevalence of GHD was 6.6% in CF patients, whereas the prevalence GHD in the normal population of childhood is <1%. Therefore, further studies should be designed to investigate the cause of GHD in CF patients.
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