Impact of Growth Hormone on Skeletal Muscle Strength, Power, Endurance, and Agility in Prepubertal Boys With Short Stature
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Published on: January 7, 2016
Ashish Malpani1, Lurah Welch1, Daniel Plummer2
1Division of Endocrinology, Nemours Children's Health, Jacksonville, FL 32207, USA.
Insights
Growth hormone (GH) treatment improved muscle strength and endurance in prepubertal boys with short stature (SS). After 12 months, GH-treated boys showed significant gains, approaching control levels in key physical metrics.
Area of Science:
- Pediatric Endocrinology
- Skeletal Muscle Physiology
- Growth Hormone Therapy
Background:
- Growth Hormone (GH) is known to enhance muscle strength and aerobic capacity in adults with GH deficiency.
- However, the specific effects of GH on skeletal muscle in youth are less understood.
- Short stature (SS) in children can be associated with underlying conditions affecting growth and development.
Purpose of the Study:
- To investigate the impact of GH on skeletal muscle function in boys with significant short stature (SS).
- To compare muscle characteristics in SS boys receiving GH treatment with age-matched, normally growing controls.
- To assess changes in muscle strength, power, endurance, and agility over a 12-month period.
Main Methods:
- An open-label, comparator study involving 45 prepubertal boys (30 with SS, 15 controls).
- Participants underwent anthropometry, fat-free mass assessment, resting energy expenditure (REE) measurement, and muscle testing at baseline, 6, and 12 months.
- The SS group received daily GH treatment, while controls were observed.
Main Results:
- At baseline, boys with SS exhibited lower upper and lower body muscle strength and lower endurance compared to controls.
- After 12 months of GH treatment, significant improvements in these muscle metrics were observed in the SS group, approaching control values.
- Adjusting for height and fat-free mass reduced some detected differences, but lower extremity muscle strength deficits persisted.
Conclusions:
- Boys with significant short stature demonstrate quantifiable deficits in skeletal muscle strength and physical endurance compared to their normally growing peers.
- A 12-month course of Growth Hormone (GH) treatment can effectively improve these muscle-related metrics in prepubertal boys with SS.
- GH therapy represents a viable intervention for addressing musculoskeletal impairments associated with short stature in pediatric populations.
Context:
Growth hormone (GH) enhances muscle strength and aerobic capacity in adults with GH deficiency, but GH effects in skeletal muscle are less well characterized in youth.
Objective:
To investigate the impact of GH on skeletal muscle in boys with significant short stature (SS) compared with age-matched, normally growing controls.
Methods:
This was an open-label comparator at an outpatient endocrine clinic. Participants were 45 prepubertal boys, SS, n = 30 (isolated GH deficiency or idiopathic SS) (mean [SE] age: 8.9 ± 0.3 years; height SDS: -2.3 ± 0.1); controls, n = 15 (8.8 ± 0.4 years; HT SDS: -0.3 ± 0.2). Anthropometry, fat-free mass, resting energy expenditure (REE) and muscle testing was performed at baseline, and 6 and 12 months after daily GH (SS group) or observation (controls). The main outcome measures were skeletal muscle strength (isometric dynamometry (flexion/extension) upper and lower extremities) (principal), power (vertical jump), endurance (modified pushups), and agility (timed shuttle-runs); fat-free mass accrual and REE (secondary).
Results:
At baseline, the SS group had lower muscle strength in upper body (P ≤ .027) and lower body (P ≤ .007) vs controls, similar lower body muscle power and agility, but lower endurance (P = .048). Baseline differences were significantly less after GH treatment, with values in children approaching those of controls by 12 months. Adjusting for height SDS and fat-free mass between groups decreases detected differences in upper extremity muscle strength and endurance, but lower extremity muscle strength differences persist. No differences in REE were detected.
Conclusion:
Boys with significant SS have quantifiable deficits in upper and lower body skeletal muscle strength, and lower physical endurance than normally statured controls. GH treatment for 12 months can improve these metrics in prepubertal boys with SS.
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