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Thyroid Function in Children and Adolescents With Idiopathic Growth Hormone (GH) Deficiency After Initiation of
Aristeidis Giannakopoulos1, Maria Tsanti1, Ioannis Amplianitis1
1Department of Pediatrics, Division of Endocrinology, Medical School, University of Patras, Patras, Greece.
Objective:
Growth hormone (GH)/insulin-like growth factor 1 (IGF-1) and thyroid axes are interconnected. Previous studies reported mixed findings regarding the effect of recombinant GH (rGH) therapy on thyroid function in children with GH deficiency (GHD). This study aimed to investigate longitudinal thyroid function changes over the first year of rGH therapy and assess the secretory capacity of the thyroid gland, using the Structure Parameter Inference Approach (SPINA-GT).
Methods:
Prospective longitudinal cohort study in a single tertiary center.
Results:
A total of 111 children with idiopathic GHD were treated with rGH (0.22 mg/kg/wk). Baseline median age was 10.0 years, with 84% being prepubertal. After 12 months of rGH therapy, IGF-1 levels significantly increased (P < .001), whereas free T4 (FT4) levels modestly declined (P = .008). Thyroid-stimulating hormone (TSH) and SPINA-GT index did not show significant changes. Mixed-effects modeling analysis revealed association of FT4 with IGF-1 SD score (P < .001), whereas TSH was not associated with any covariate.
Conclusion:
The findings of our study are consistent with most previous studies, confirming that rGH therapy in children with GHD induces a modest, statistically significant decline in FT4 while maintaining stable TSH. FT4 was associated with the increase of IGF-1 SD score during rGH therapy while the addition of SPINA-GT evaluation supports the preservation of the thyroid secretory reserve during the first year of rGH treatment.
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