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Growth hormone secretion in normal prepubertal children: importance of relations between endogenous secretion,
T Martín-Hernández1, M Díaz Gálvez, A Torres Cuadro
1Service of Endocrinology, University Hospital, Virgen Macarena, Seville, Spain.
Insights
Higher body mass in normal-weight prepubertal children is linked to reduced growth hormone (GH) secretion and altered pulsatility. These findings highlight the importance of considering body mass when assessing GH levels in children.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Physiology
- Childhood Obesity Research
Background:
- A negative relationship between growth hormone (GH) secretion and body mass is known.
- Few studies have investigated this relationship in prepubertal children of normal weight and height.
Purpose of the Study:
- To examine the relationship between GH secretion, pulsatility, and body mass in normal prepubertal children across a wide weight range.
- To establish normative data for GH secretion in relation to body mass index standard deviation scores (BMI-SD).
Main Methods:
- Integrated GH concentrations (day, night, 24-hour) were measured in 46 prepubertal children (BMI-SD: +2 to -2).
- GH secretory profiles were analyzed using the Pulsar program for parameters like area under the curve (AUC) and peak number (NP) in 28 children.
- Pulse characteristics (e.g., amplitude, area) were categorized as large or small based on predefined thresholds.
Main Results:
- A significant negative correlation was found between BMI-SD and integrated GH concentrations (IC-GH) and Pulsar parameters.
- Higher BMI-SD was associated with lower 24-hour AUC and fewer high spontaneous peaks (HSP).
- The number of large daytime GH pulses (NLDP) showed a stronger inverse correlation with BMI-SD than nighttime pulses.
Conclusions:
- Body mass is a critical factor influencing GH secretion and pulsatility in prepubertal children.
- It is essential to consider body mass when evaluating GH secretion to distinguish normal from pathological patterns.
- This study provides valuable insights for diagnosing GH-related disorders in children.
Objective:
Although a negative relation between GH secretion and body mass has been described, few studies have been carried out in prepubertal subjects of normal weight and height. The aim of the present study was to examine the relations between GH secretion, pulsatility and body mass throughout the wide range of weights in normal prepubertal children.
Methods:
We determined integrated GH concentrations during the day (IC-GHD), night (IC-GHN), and 24 hours (IC-GH24) in 46 prepubertal children (26 males, 20 females) of normal height and growth velocity and with a Z-score (BMI-SD) between +2 and -2 SD. In addition, in 28 of these patients randomized by their BMI-SD, the secretory profile was studied by the Pulsar program: area under curve (AUC), peak number (NP), high spontaneous peak of secretory profile (HSP), and area of pulses (AP) which were considered large (L) or small (S) if their amplitude was greater or less than 4 micrograms/l (8 mU/l).
Results:
BMI-SD correlated negatively with IC-GH (IC-GHD, IC-GH24, r = -0.58, P < 0.001) and with Pulsar parameters r = -0.48, P < 0.001; IC-GHN, r = -0.45, P < 0.001; (AUC-24, r = -0.73, P < 0.0001; HSP, r = -0.65, P < 0.0001). The NP correlated negatively with BMI-SD (r = -0.51, P < 0.005) at the expense of NLP (r = -0.54, P < 0.003) without being significantly correlated with NSP. This inverse correlation between BMI-SD and NLP was greater during daytime (NLDP, r = -0.60, P < 0.001) and was not significant at night. NSP did not correlate with BMI-SD. A similar relation was observed with respect to pulse area (ALP, r = -0.38, P < 0.05; ALDP, r = -0.46, P < 0.02;) and was not significant for ALP during the night or for ASP in any period.
Conclusions:
We suggest that it should be necessary to relate GH secretion to body mass in prepubertal children before defining their secretion as normal or pathological.