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Effect of asthma treatment on urinary growth hormone excretion in children
P C O'Leary1, E McIntyre, P Feddema
1University Department of Obstetrics and Gynaecology, Princess Margaret and King Edward Memorial Hospitals, Subiaco, Western Australia.
Insights
Childhood asthma treatments, including corticosteroids, do not appear to affect growth hormone (GH) secretion. This study found no significant differences in GH levels in urine samples from children with asthma compared to healthy controls.
Area of Science:
- Pediatric Endocrinology
- Pulmonology
- Biochemistry
Background:
- Childhood asthma is a common chronic respiratory disease.
- Growth hormone (GH) is crucial for growth and development in children.
- Concerns exist regarding potential endocrine side effects of asthma medications, particularly corticosteroids.
Purpose of the Study:
- To investigate the impact of various asthma therapies on growth hormone (GH) secretion in prepubertal children.
- To compare GH levels in children with asthma undergoing different treatment regimens against a healthy control group.
Main Methods:
- Urine samples were collected from 110 prepubertal children, including healthy controls and children with asthma on different treatments (untreated, inhaled corticosteroids, oral corticosteroids, non-corticosteroidal therapies).
- Growth hormone (GH) concentrations were measured in first morning urine samples using enzyme immunoassay.
- GH levels were analyzed both directly (ng/L) and corrected for urine creatinine concentration (ng GH/mmol).
Main Results:
- No significant differences in mean urine GH concentrations were observed between healthy children and children with asthma across all treatment groups.
- GH excretion levels remained similar regardless of whether samples were expressed as ng/L or corrected for creatinine.
- High intra-individual variability in urine GH measurements was noted, with coefficients of variation ranging up to 92%.
Conclusions:
- Current asthma therapies, including inhaled and oral corticosteroids, do not demonstrate an adverse effect on growth hormone secretion in prepubertal children.
- The study suggests that standard asthma treatments are unlikely to impair GH-dependent growth in this population.
- Further research may be needed to address the high variability observed in urine GH measurements.
Abstract:
We measured growth hormone (GH) concentrations in first morning urine samples in 110 prepubertal children to determine whether asthma therapies affected GH secretion. The children with asthma were assigned to two groups depending on their asthma treatments: 1) 16 children with a history of asthma, currently not on any treatment, and 2) asthmatics taking inhaled corticosteroids (n = 37), short-term oral corticosteroids (n = 15), or long-term non-corticosteroidal therapies (n = 19). Results obtained from these children were compared with a control group of healthy prepubertal children (n = 23) without previous or current symptoms of asthma. Five consecutive urine samples were collected from each child, and GH concentrations (corrected for urine creatinine) were determined by an enzyme immunoassay. The mean (+/- SD) urine GH concentration determined in the control group (23 healthy prepubertal children) was 15.6 +/- 8.7 ng/L (1.88 +/- 1.29 ng GH/mmol creatinine). The mean (+/- SD) urine GH concentrations in overnight samples were similar in untreated asthmatics (14.1 +/- 6.1 ng/L) and in the treatment groups (14.1 +/- 7.7 ng/L, inhaled corticosteroids; 16.5 +/- 11.7 ng/L, oral corticosteroids; 15.9 +/- 9.8 ng/L, long-term non-corticosteroidal therapies). Irrespective of the manner of expression of urine GH (ng/L) or after correction for urine creatinine concentration (ng GH/mmol), no significant differences were found in the GH excretion among any of the groups. In this study, the intra-individual coefficient of variation for urine GH, expressed as ng/L, ranged between 11 and 87% (median, 32%). When the urine GH was expressed as ng GH/mmol creatinine, the coefficient of variation ranged between 12 and 92% (median, 35%), accounting for approximately 60% of the inter-individual coefficient of variation (mean CV, 56%) and 47% when the urine GH is expressed as ng GH/mmol creatinine. We were unable to determine any short-term differences in urine GH excretion between non-asthmatic children and asthmatics treated with inhaled corticosteroids, oral corticosteroids, or bronchodilators. Our results suggest that there is not an adverse effect of current corticosteroid therapies for childhood asthma on GH secretion.