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Published on: January 17, 2018
Retrospective analysis of growth hormone effects on growth and adenoma volume in children with pituitary microadenoma
Dandan Pan1, Zhongyan Liu2, Yao Yu1
1Department of Preventive Healthcare, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Background:
Pituitary microadenomas (PMs) are increasingly identified in children evaluated for growth or pubertal concerns; uncertainty about tumor behavior often delays growth hormone (GH) therapy. This study aimed to assess the efficacy and short-term safety of recombinant human growth hormone (rhGH) plus leuprorelin in children with PM.
Methods:
We retrospectively reviewed 22 children who received rhGH plus leuprorelin. Growth parameters, including height, bone age (BA), BA minus chronological age (CA), height standard deviation score (HtSDS), and predicted adult height (PAH), were compared before and after treatment using paired-sample t-tests. PM volumes at different time points (pre-treatment, during treatment, and post-treatment) were analyzed using repeated measures analysis of variance (ANOVA). Safety indicators such as fasting blood glucose (FBG), fasting insulin (FINS), insulin-like growth factor-1 (IGF-1), and IGF-1 standard deviation score (IGF-1 SDS), along with thyroid function markers including thyroid-stimulating hormone (TSH), free serum triiodothyronine (FT3), and free serum thyroxine (FT4), were evaluated over 0, 3, 6, 9, and 12 months via repeated measures ANOVA. All tests were two-tailed, and P<0.05 was considered statistically significant.
Results:
The mean durations of GH and leuprorelin treatment were 1.75 and 1.57 years, respectively. After therapy, BA-CA decreased from 1.08 to 0.40 years (Δ =-0.68 years; P<0.001), HtSDS increased by 0.41 (P=0.003), and PAH improved by 7.43 cm (P<0.001). FBG, FINS, and thyroid function markers (TSH, FT3, FT4) remained stable over 1 year. Tumor volume decreased by 2.72 mm3 compared to baseline, but this change was not statistically significant (P=0.18). Female and male subgroups differed significantly in PAH and BA-CA improvements (P<0.05).
Conclusions:
Combined GH and leuprorelin enhances linear growth and delayed bone maturation in children with PM and compromised PAH, without promoting tumor growth or sustained IGF-1 elevation.
