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Collagen formation and degradation increase during growth hormone therapy in children
E Vihervuori1, M Turpeinen, M A Siimes
1Children's Hospital, University of Helsinki, Finland.
Insights
Human growth hormone (hGH) treatment for short stature in children stimulates collagen formation and degradation markers. These collagen markers closely correlate with height velocity during treatment.
Area of Science:
- Biochemistry
- Pediatric Endocrinology
- Metabolic Bone Disease
Background:
- Short stature in children can be treated with human growth hormone (hGH).
- Understanding the biochemical markers of growth and collagen turnover is crucial during hGH therapy.
- Previous studies have not comprehensively evaluated collagen markers longitudinally during hGH treatment in short children.
Purpose of the Study:
- To investigate serum markers of collagen turnover and growth in prepubertal short children during hGH treatment.
- To correlate these markers with height velocity and assess their changes over 12 months of treatment.
- To explore the relationship between collagen formation and degradation markers during induced growth.
Main Methods:
- Longitudinal study of 18 prepubertal short children receiving hGH treatment.
- Measurement of serum markers: carboxyterminal propeptide of type I procollagen (PICP), carboxyterminal telopeptide of type I collagen (ICTP), amino-terminal propeptide of type III procollagen (PIIINP), alkaline phosphatase (AP), osteocalcin (OC), insulin-like growth factor-I (IGF-I), and insulin-like growth factor binding protein-3 (IGFBP-3).
- Correlation analysis of marker concentrations and increments with subsequent height velocity.
Main Results:
- Serum collagen markers (PICP, ICTP, PIIINP) and IGFBP-3 increased during hGH treatment and paralleled height velocity changes.
- ICTP and PIIINP levels correlated significantly throughout the study.
- Increments in ICTP, PIIINP, and IGFBP-3 one week after treatment initiation correlated with subsequent height velocity.
Conclusions:
- Serum collagen formation and degradation markers are closely associated with linear body growth during hGH treatment in short children.
- ICTP and PIIINP appear to be reliable indicators of collagen turnover during hGH-induced growth.
- These findings highlight the role of collagen metabolism in mediating the effects of hGH on linear growth.
Abstract:
A comprehensive set of serum markers of collagen turnover and growth was investigated in a longitudinal study of short children during growth induced by growth hormone (hGH) treatment. The study comprised 18 prepubertal children with short stature who had no other current illness or continuous medication. The growth rates and endogenous GH secretions covered a continuum from subnormal to normal. Before treatment, the concentrations of carboxyterminal propeptide of type I procollagen (PICP), reflecting type I collagen formation, of carboxyterminal telopeptide of type I collagen (ICTP), a degradation product of type I collagen, of amino-terminal propeptide of type III procollagen (PIIINP), a marker for type III collagen formation, of alkaline phosphatase (AP), and of insulin-like growth factor binding protein-3 (IGFBP-3) were within the lower limits of normal. The median IGF-I concentration was lower than the reference. One week after the start of treatment, the serum concentrations of ICTP, PIIINP, and osteocalcin (OC), and the increments in ICTP, PIIINP, and IGF binding protein-3 (IGFBP-3) correlated with the subsequent height velocity. During the 12-month treatment, all markers were higher than those of age-matched references, but only the three collagen markers paralleled the changes in height velocity. In molar concentrations, ICTP increased less than PICP. Throughout the study period, the serum level of ICTP correlated with that of PIIINP, but not with that of PICP. The findings suggest that during hGH treatment, linear body growth is closely associated with collagen formation and degradation.