Metabolic effects of human growth hormone in corticosteroid-treated children

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy
• Pharmacology

Background:

• Children with chronic diseases often require long-term corticosteroid therapy.
• Corticosteroids can impact various physiological processes, including growth.
• Human growth hormone (HGH) is used to treat growth disorders in children.

Purpose of the Study:

• To evaluate the effects of administered human growth hormone (HGH) in dwarfed, prepubertal children receiving long-term corticosteroid therapy.
• To determine if corticosteroids antagonize the effects of HGH on growth and metabolism.

Main Methods:

• Conducted 11 metabolic balance studies in prepubertal children.
• Administered HGH to corticosteroid-treated children, hypopituitary subjects, and asthmatic children not on corticosteroids.
• Monitored nitrogen, phosphorus, and potassium retention and growth rates.

Main Results:

• Corticosteroid-treated children showed impaired HGH response with minimal nitrogen and no phosphorus retention.
• Hypopituitary and non-corticosteroid-treated asthmatic children responded to HGH with significant retention.
• Corticosteroid-treated children receiving high-dose HGH showed no growth improvement, unlike hypopituitary subjects.

Conclusions:

• Dwarfism in children on corticosteroid therapy is likely due to corticosteroid-induced antagonism of HGH effects at the peripheral tissue level.
• Corticosteroids significantly inhibit the metabolic and growth-promoting actions of HGH.
• This finding has implications for managing growth in children requiring long-term corticosteroid treatment.