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Human growth hormone blunts Na2EDTA-induced hypocalcaemia in hyposomatotrophic children
Insights
Human growth hormone (hGH) treatment in children with hyposomatotropism increased calcium levels over 12 months. This study monitored calcium and parathyroid hormone (PTH) levels during hGH therapy.
Area of Science:
- Pediatric Endocrinology
- Calcium Metabolism
- Hormone Therapy
Background:
- Hyposomatotropism, a condition of growth hormone deficiency, affects children's development.
- Growth hormone therapy (hGH) is a standard treatment for hyposomatotropism.
- Calcium homeostasis and parathyroid hormone (PTH) regulation are critical during growth and development.
Purpose of the Study:
- To investigate the effects of human growth hormone (hGH) treatment on calcium and parathyroid hormone (PTH) levels in children with hyposomatotropism.
- To assess changes in total and ionized calcium concentrations during hGH therapy.
- To evaluate the impact of hGH on basal and stimulated PTH secretion.
Main Methods:
- A cohort of 10 children with hyposomatotropism received hGH treatment for 12 months.
- Disodium ethylenediamine tetraacetate (Na2EDTA) infusions were administered to assess calcium and PTH responses.
- Blood samples were collected pre-treatment, and at 6 and 12 months post-treatment for analysis of total calcium, ionized calcium, and immunoreactive PTH (iPTH).
Main Results:
- Mean basal total and ionized calcium concentrations did not change significantly during hGH treatment.
- However, the nadir (lowest point) concentrations of total and ionized calcium progressively increased during hGH administration.
- After 12 months of hGH treatment, both total and ionized calcium levels were significantly higher than pre-treatment values.
- Basal iPTH levels showed a slight but significant increase after 12 months of hGH therapy.
- Na2EDTA-stimulated iPTH secretion remained unaltered by hGH treatment.
Conclusions:
- Human growth hormone (hGH) therapy in children with hyposomatotropism leads to a significant increase in total and ionized calcium levels after 12 months.
- While basal iPTH levels may slightly increase, hGH does not significantly alter the parathyroid glands' ability to respond to hypocalcemia.
- These findings highlight the impact of hGH on calcium metabolism in growing children and suggest careful monitoring of calcium levels during treatment.
Abstract:
An infusion of disodium ethylenediamine tetraacetate (Na2EDTA) (0.13 mmol/kg for 2 h) was administered to 10 hyposomatotrophic children prior to and after 6 and 12 months of treatment with human growth hormone (hGH). Total and ionized calcium and immunoreactive parathyroid hormone (iPTH) concentrations were determined. Mean basal total and ionized calcium concentrations did not change during the year of treatment with hGH. The nadir concentrations of total and ionized calcium increased progressively during hGH administration and after 12 months were significantly increased over pre-treatment values (total calcium: pretreatment 1.85 +/- 0.32 (SD) mmol/l, +12 months 2.10 +/- 0.15, P less than 0.01; ionized calcium: pre-treatment 0.55 +/- 0.31 mmol/l, +12 months 0.78 +/- 0.14, P less than 0.05). The mean basal concentration of iPTH increased slightly after 12 months of hGH administration (pre-treatment 72 +/- 18 pg/ml, +12 months 106 +/- 71, P less than 0.05), but Na2EDTA-evoked secretion of iPTH was not significant altered by hGH.