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Urinary growth hormone in growth-impaired children with chronic inflammatory bowel disease
C P Braegger1, T Torresani, S H Murch
1Department of Paediatric Gastroenterology, St. Bartholomew's Hospital, London, England.
Insights
Growth impairment in children with chronic inflammatory bowel disease is not linked to growth hormone deficiency. Other mechanisms likely cause growth retardation in pediatric inflammatory bowel disease patients.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Growth Disorders
Background:
- Chronic inflammatory bowel disease (IBD) affects approximately 30% of children, leading to growth impairment of unknown origin.
- Understanding the etiology of growth failure in pediatric IBD is crucial for effective management.
Purpose of the Study:
- To investigate the role of urinary growth hormone (UGH) concentrations in children with IBD-related growth impairment.
- To determine if growth hormone deficiency contributes to growth retardation in pediatric IBD.
Main Methods:
- Urinary growth hormone concentrations were measured in 36 children with chronic IBD (some stunted, some normal growth) and 51 healthy controls.
- Statistical analysis was performed to compare UGH levels between groups and correlate with growth status and corticosteroid treatment.
Main Results:
- No statistically significant difference in median UGH concentrations was found between stunted IBD children and those with normal growth.
- No significant difference in UGH levels was observed between IBD patients and the control group.
- A higher proportion of stunted patients (80%) were on corticosteroid treatment compared to those with normal UGH (26%), suggesting a potential confounding factor.
Conclusions:
- Growth retardation in children with chronic IBD is unlikely to be caused by growth hormone deficiency.
- Other underlying mechanisms, potentially influenced by corticosteroid treatment, are more likely responsible for growth impairment in pediatric IBD.
Abstract:
Growth impairment of undefined aetiology occurs in approximately 30% of children with chronic inflammatory bowel disease. We measured urinary growth hormone concentrations in 36 children with chronic inflammatory bowel disease and 51 normal controls. The median urinary concentration of growth hormone in the stunted children with chronic inflammatory bowel disease was 15.8 ng/g creatinine (range 4.3-32.6), compared with 11.7 ng/g creatinine (range 4.1-35.9) in those with normal growth. The difference was statistically not significant (p = 0.15). Moreover, there was no significant difference between the patients and the control group. One stunted patient had a urinary growth hormone (UGH) concentration below the normal range, whereas four patients with normal height were also below the normal range. Four of these five patients (80%) were on corticosteroid treatment at the time of urinary collection, whereas only 26% of the patients with normal UGH were also on corticosteroid treatment. We conclude that growth retardation in children with chronic inflammatory bowel disease is probably not related to growth hormone deficiency but must involve other mechanisms.