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Growth and metabolic consequences of growth hormone treatment in prepubertal short normal children
E S McCaughey1, J Mulligan, L D Voss
1Department of Child Health, Southampton University Hospitals Trust.
Insights
Growth hormone therapy in short children significantly increases height prediction. However, it leads to reduced body fat and higher insulin levels after three years, with uncertain long-term outcomes.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Research
Background:
- Short stature in children can impact psychosocial well-being.
- Growth hormone (GH) is a key regulator of linear growth.
- Understanding GH's metabolic effects is crucial for therapeutic use.
Purpose of the Study:
- To evaluate the efficacy of Genotropin for increasing height in short, normal, prepubertal children.
- To assess the metabolic effects of long-term growth hormone treatment.
- To compare growth and body composition outcomes between treated and untreated children.
Main Methods:
- A randomized controlled trial involving 41 short, normal, prepubertal children.
- Daily injections of growth hormone (Genotropin, 30 IU/m2/week) administered to the treated group.
- Monitoring of growth parameters, adult height prediction, body fat percentage, and insulin levels over three years.
Main Results:
- Children treated with growth hormone showed significantly greater growth and improved adult height prediction compared to controls.
- The treated group exhibited significantly lower body fat percentage (13.5% vs. 18%).
- Hyperinsulinemia was observed in the treated group (66.7 pmol/l vs. 44.5 pmol/l) after three years.
Conclusions:
- Growth hormone therapy enhances height potential in short, normal prepubertal children.
- Long-term treatment is associated with reduced adiposity and altered insulin sensitivity.
- Further research is needed to ascertain the definitive long-term outcomes and safety profile.
Abstract:
Growth and the metabolic effects of growth hormone were monitored in a randomised, controlled group of 41 short, normal, prepubertal children. The treated group received daily injections of growth hormone as Genotropin (Kabi Pharmacia) 30 IU/m2/week. Fifteen children in the treated group (21 children) have completed three years of treatment, have grown significantly more than 14 (of 20) untreated children, and have a significantly greater adult height prediction. They do, however, remain leaner (body fat 13.5% in the treated group, 18% in the untreated group) and relatively hyperinsulinaemic (insulin 66.7 pmol/l in the treated group, 44.5 in the untreated group) after three years compared with untreated children. Although growth hormone appears to improve the height potential of prepubertal short normal children, the long term outcome is still uncertain.