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Thyroid function in non-growth hormone-deficient short children during a placebo-controlled double blind trial of
S R Rose1, G M Leong, J A Yanovski
1Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892.
Insights
Growth hormone (GH) treatment in short children without GH deficiency did not significantly alter thyroid function over 12 months. Thyroid hormone levels and TSH response remained stable, indicating no sustained effects on thyroid health.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Thyroid Function Tests
Background:
- Previous studies indicate growth hormone (GH) treatment can affect thyroid hormones in GH-deficient children.
- The impact of GH on thyroid function in non-GH-deficient short children remains less understood.
Purpose of the Study:
- To investigate the effects of GH treatment on thyroid function in short children without GH deficiency.
- To assess changes in thyroid hormones (T4, free T4, T3) and thyroid-stimulating hormone (TSH) levels.
Main Methods:
- A 12-month randomized, placebo-controlled trial involving 20 short children (9 GH group, 11 placebo).
- Regular measurements of total T4, free T4, T3, and TSH at baseline and various time points.
- Thyrotropin-releasing hormone (TRH) stimulation tests and nocturnal TSH surge measurements were performed.
Main Results:
- No significant differences in total T4, free T4, T3, or TSH levels were observed between the GH and placebo groups throughout the 12-month study.
- TSH response to TRH and nocturnal TSH surge patterns did not differ significantly between the groups.
- While a transient early effect cannot be ruled out, no sustained alterations in thyroid function were detected.
Conclusions:
- Twelve months of GH treatment does not lead to sustained changes in thyroid function in short children without GH deficiency.
- GH therapy appears safe concerning thyroid function in this specific pediatric population.
- Further research may explore potential transient effects or long-term outcomes.
Abstract:
GH treatment in GH-deficient children has been reported to cause decreases in serum T4 and TSH and an increase in serum T3. We sought to determine whether GH treatment alters thyroid function in non-GH-deficient short children. Twenty children (18 boys) were followed for 12 months while receiving either GH (Humatrope, Eli Lilly; 0.074 mg/kg, sc, 3 times/week; n = 9) or placebo (n = 11). Total T4, free T4, T3, and TSH were measured every 6 months and in 12 children also at 1, 2, 3, and 9 months. A TRH test and measurement of nocturnal TSH surge were performed at baseline and after 6 months of treatment in 19 subjects. There were no significant differences at baseline in the clinical features between the placebo and GH groups. Total T4, free T4, T3, and TSH levels did not significantly differ between the placebo and GH groups at baseline and at 1, 2, 3, 6, 9, and 12 months. There were no significant differences between the two groups in TSH response to TRH or nocturnal TSH surge. Although an early transient effect of GH treatment could not be excluded, we conclude that GH treatment for 12 months does not produce sustained alterations in thyroid function in non-GH-deficient children.