Related Experiment Video
Updated: Jun 19, 2025
Comparative Analysis of Human Growth Hormone in Serum Using SPRi, Nano-SPRi and ELISA Assays
Published on: January 7, 2016
Thyroid hormone levels in children with Prader-Willi syndrome: a randomized controlled growth hormone trial and
Demi J Trueba-Timmermans1,2,3, Lionne N Grootjen1,2,3, Gerthe F Kerkhof1,3
1Dutch Reference Center for Prader-Willi Syndrome, 3015 CN Rotterdam, The Netherlands.
Insights
Growth hormone (GH) treatment in children with Prader-Willi syndrome (PWS) initially lowers free thyroxine (FT4) due to increased conversion to T3. Levels then stabilize with long-term GH therapy, indicating safety for thyroid function.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Hormone Therapy
Background:
- Prader-Willi syndrome (PWS) is associated with endocrine abnormalities, including hypothyroidism.
- Growth hormone (GH) therapy in PWS may influence the thyroid hormone axis, potentially affecting thyroxine (T4) and thyroid-stimulating hormone (TSH) levels.
Purpose of the Study:
- To evaluate thyroid function, specifically free thyroxine (FT4) and triiodothyronine (T3), during GH treatment in a large cohort of children with PWS.
- To assess the impact of GH therapy on the thyroid hormone axis in pediatric PWS patients.
Main Methods:
- Serum FT4, T3, and TSH levels were measured in a 2-year randomized controlled trial (RCT) and a 10-year longitudinal GH study.
- GH treatment involved a dosage of 1.0 mg/m²/day (approximately 0.035 mg/kg/day).
- Thyroid function parameters were analyzed using standard deviation scores (SDS).
Main Results:
- In the 2-year RCT, GH treatment led to a significant decrease in FT4 SDS within the first 6 months (P < .001), while T3 SDS showed a trend toward increase (P = .08).
- In the 10-year study, FT4 SDS remained stable between 2 and 10 years (P = .13).
- TSH SDS significantly decreased between 2 and 10 years of GH treatment (P < .001).
Conclusions:
- GH treatment in children with PWS initially reduces FT4 levels, likely due to increased peripheral conversion to T3.
- FT4 and T3 levels normalize and remain stable during extended GH treatment.
- Long-term GH therapy appears safe for the thyroid hormone axis in most children and adolescents with PWS.
Context:
Several endocrine abnormalities were reported in children with Prader-Willi syndrome (PWS), including hypothyroidism. Growth hormone (GH) treatment may impact the thyroid hormone axis by direct inhibition of T4 or TSH secretion or by increased peripheral conversion of free T4 (FT4) to T3.
Objective:
The objective of this study is to evaluate thyroid function during GH treatment in a large group of children with PWS.
Methods:
Serum FT4, T3, and TSH are measured in a 2-year randomized controlled GH trial (RCT) and 10-year longitudinal GH study (GH treatment with 1.0 mg/m²/day [∼0.035 mg/kg/day]).
Results:
Forty-nine children with PWS were included in the 2-year RCT (median [interquartile range, IQR] age: GH group 7.44 [5.47-11.80] years, control group 6.04 [4.56-7.39] years). During the first 6 months, median (IQR) FT4 standard deviation score (SDS) decreased in the GH group from -0.84 (-1.07 to -0.62) to -1.32 (-1.57 to -1.08) (P < .001) and T3 SDS increased from 0.31 (-0.01-0.63) to 0.56 (0.32-0.79) (P = .08), while in the control group, FT4 and T3 SDS remained unchanged. In our 10-year GH study, 240 children with PWS (median [IQR] age: 1.27 (0.54-4.17) years] were included. Between 2 and 10 years, median (IQR) FT4 SDS remained unchanged, being -0.87 (-0.98 to -0.77) after 2 years and -0.88 (-1.03 to -0.74) after 10 years (P = .13). TSH SDS decreased from -0.35 (-0.50 to -0.21) after 2 years to -0.68 (-0.84 to -0.53) after 10 years (P < .001).
Conclusions:
Our findings suggest that GH treatment decreases FT4 levels, due to increased peripheral conversion of FT4 to T3 in the first months of treatment, but thereafter, FT4 and T3 normalize and remain stable during long-term GH treatment in almost all children and adolescents with PWS.
Related Concept Videos
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
01:27Major Hormones and Their Functions
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:10Nature and Nurture
01:27Signs of Puberty