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Majewska KA, Tchorzewska-Skrobich M, Wais P, Majewski D, Naskręcka M, Kędzia A. Deficient or Normal Growth Hormone Secretion in Polish Children with Short Stature: Searching for Clinical Differences. Biomedicines 2024; 12:1673. [PMID: 39200139 PMCID: PMC11351400 DOI: 10.3390/biomedicines12081673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/21/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
Short stature affects approximately 2.5% of children. Some of them, when diagnosed with growth hormone deficiency (GHD), benefit from recombinant human growth hormone (rhGH) therapy; in others, this treatment is controversial. We aimed to present the clinical characteristics of Polish short stature children in the context of current GHD diagnostic standards, as obtaining more data gives a broader foundation for the potential modifications of diagnostic and therapeutic recommendations. This retrospective analysis was based on a cohort of 277 short stature children divided into two subgroups depending on their peak growth hormone (GH) cutoff level, set at 10 ng/mL: 138 had growth hormone deficiency (GHD) and 137 had normal growth hormone secretion (GHN). These subgroups were then compared based on the extracted clinical data. In the obtained result, no significant differences between the GHD and GHN subgroups were found in any of the variables, including the following: gender distribution, birth weight, bone age delay, height SDS, IGF-1 SDS, vitamin D levels, celiac disease indices, prevalence of hypothyroidism or anemia. As our results point to major clinical similarities between the GHD and GHN children, it seems that distinguishing patients with normal GH secretion from those with deficient GH secretion based on a 10 ng/mL cutoff value might not be clinically relevant.
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Affiliation(s)
- Katarzyna Anna Majewska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
| | - Magdalena Tchorzewska-Skrobich
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
| | - Paulina Wais
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
| | - Dominik Majewski
- Department of Internal Medicine, Poznan University of Medical Sciences, 60-780 Poznan, Poland;
| | - Monika Naskręcka
- Department of Applied Mathematics, Poznan University of Economics and Business, 61-875 Poznan, Poland
| | - Andrzej Kędzia
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
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Torlińska-Walkowiak N, Majewska KA, Sowińska A, Kędzia A, Opydo-Szymaczek J. Developmental enamel defects and dental anomalies of number and size in children with growth hormone deficiency. Sci Rep 2023; 13:14707. [PMID: 37679467 PMCID: PMC10484903 DOI: 10.1038/s41598-023-41892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023] Open
Abstract
Growth hormone is meaningfully involved in the processes of tooth cells differentiation and tissue formation. The aim of the study was to evaluate the occurrence of dental anomalies: microdontia, macrodontia, hypodontia and developmental defects of enamel (DDE) amongst a group of isolated growth hormone deficient (GHD) patients and healthy children. This cross-sectional study was based on a group of 101 Caucasian children: 33 with GHD (mean age 10.94, SD 2.51) and 68 being healthy, normal height subjects (mean age 10.4, SD 2.38). The dental examination in primary and permanent teeth was carried out by one trained and calibrated dentist, in accordance with the WHO guidelines. It was observed that 33% of GHD patients suffer from dental anomalies (hypodontia, microdontia or macrodontia), the difference between the study group and the control group was statistically significant (33% vs 4%, p < 0.001). Hypodontia and microdontia/macrodontia were the most common problems affecting 18% and 21% of the GHD individuals, respectively. The prevalence of DDE did not differ significantly between GHD group and the control group (58% vs 48%, p > 0.05). As children with GHD present more dental anomalies than their healthy coevals, clinicians should be aware of the possible oral health problems associated with GHD and consider dental screening and management as part of the patient's overall health care plan.
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Affiliation(s)
- Natalia Torlińska-Walkowiak
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland.
| | - Katarzyna A Majewska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Anna Sowińska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806, Poznan, Poland
| | - Andrzej Kędzia
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland
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Agrawal N, Gersey ZC, Abou-Al-Shaar H, Gardner PA, Mantica M, Agnihotri S, Mahmud H, Fazeli PK, Zenonos GA. Major Genetic Motifs in Pituitary Adenomas: A Practical Literature Update. World Neurosurg 2023; 169:43-50. [PMID: 36115566 PMCID: PMC11195535 DOI: 10.1016/j.wneu.2022.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The literature includes many studies examining the genetic abnormalities that influence pituitary adenomas (PAs). We aimed to state the collective knowledge on the genetic underpinnings of PAs by organizing, summarizing, and consolidating the literature to serve as a comprehensive review for scientists and clinicians of the most up-to-date information underlying the genetic landscape of PAs. METHODS The PubMed and Google Scholar databases were searched using multiple key words and combined Medical Subject Headings terms; only articles published in English between January 2000 and January 2022 were included. Articles in which the focus did not relate to genetics, that included mainly anecdotal evidence, or that were single case studies were eliminated. RESULTS PAs are one of the most common intracranial neoplasms. However, the genetic underpinnings for these tumors are not yet fully elucidated. There are several categories of PAs: clinically significant versus not clinically significant, functional versus nonfunctional, and germline-derived versus sporadic origin. Each of these disease subcategories is characterized by unique genetic aberrations. Recently, more genes and other types of genetic aberrations have been identified as possible causes of PAs, such as copy number variations and altered levels of microRNAs. CONCLUSIONS This review serves to consolidate and summarize the literature discussing the genetic motifs of PAs to help physicians and scientists deliver patient-centered therapies.
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Affiliation(s)
- Nishant Agrawal
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Zachary C Gersey
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hussam Abou-Al-Shaar
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Paul A Gardner
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Megan Mantica
- Departments of Neuro-Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Sameer Agnihotri
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hussain Mahmud
- Departments of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Pouneh K Fazeli
- Departments of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Georgios A Zenonos
- Departments of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
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Wu J, Chen L, Li Y, Luo J. Functional orthopedic treatment combined with differential-force technique to treat a severe mandibular retraction with growth-hormone deficiency: a case report. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2022; 40:597-605. [PMID: 38596982 PMCID: PMC9588855 DOI: 10.7518/hxkq.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/13/2022] [Indexed: 04/11/2024]
Abstract
Growth-hormone deficiency (GHD) is a common growth-related disease in children, and the main reason is the lack of growth hormone. In the oralfacial region, GHD often manifests as severe mandibular retraction, which increases the difficulty of clinical treatment. This article reports a case of severe mandibular retraction with GHD subjected to functional orthopedic treatment combined with differential-force technique, which yielded satisfactory results. This study can serve as a reference for clinical treatments of similar cases.
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Affiliation(s)
- Jiaqi Wu
- Dept. of Orthodontics, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang 330006, China
- Dept. of Stomatology, Shenzhen Children's Hospital, Shenzhen 518001, China
| | - Luyi Chen
- Dept. of Orthodontics, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang 330006, China
- Dept. of Children's Pediatric Dentistry, Shenzhen Stomatological Hospital, Shenzhen 518001, China
| | - Yuanyuan Li
- Dept. of Stomatology, People's Hospital of Pingxiang, Pingxiang 337055, China
| | - Jun Luo
- Dept. of Orthodontics, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang 330006, China
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Torlińska-Walkowiak N, Majewska KA, Sowińska A, Kędzia A, Opydo-Szymaczek J. Skeletal and dental age discrepancy and occlusal traits in children with growth hormone deficiency and idiopathic short stature. Clin Oral Investig 2022; 26:6165-6175. [PMID: 35690690 DOI: 10.1007/s00784-022-04566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/22/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate the dental and bone age delay and occlusal traits of children with growth hormone deficiency (GHD) and idiopathic short stature (ISS). MATERIAL AND METHODS The study group included 46 patients aged 5 to 14 years: 15 with ISS, 17 with GHD before growth hormone treatment, and 14 with GHD during substitution therapy. The control group consisted of 46 age and sex-matched subjects of normal height. A calibrated dentist assessed all subjects in terms of dental age and occlusal characteristics. Bone age was evaluated only in GHD and ISS children as a part of a hospital's diagnostic protocol. RESULTS The subgroup of GHD before treatment differed significantly concerning dental age delay from their healthy peers (- 0.34 and 0.83 year, respectively, p = 0.039). Dental age delay in short stature children was less marked than bone age delay (- 0.12 and - 1.76, respectively, p < 0.00001). Dental crowding was recorded in 57% of ISS patients and 53% of GHD children before treatment compared to only 22% of the control subjects (p = 0.027 and p = 0.021, respectively). CONCLUSIONS Dental age was retarded in GHD children before growth hormone (GH) therapy, but the delay does not seem clinically significant. ISS children and GHD children before therapy showed marked bone age delay and tendency to crowding. CLINICAL RELEVANCE The different pace of teeth eruption and skeletal growth in short stature children should be considered when planning their dental treatment.
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Affiliation(s)
- Natalia Torlińska-Walkowiak
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland.
| | - Katarzyna Anna Majewska
- Department of Clinical Auxology and Pediatric Nursing, Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Anna Sowińska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806, Poznan, Poland
| | - Andrzej Kędzia
- Department of Clinical Auxology and Pediatric Nursing, Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812, Poznan, Poland
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Torlińska-Walkowiak N, Majewska KA, Kędzia A, Opydo-Szymaczek J. Clinical Implications of Growth Hormone Deficiency for Oral Health in Children: A Systematic Review. J Clin Med 2021; 10:3733. [PMID: 34442031 PMCID: PMC8396810 DOI: 10.3390/jcm10163733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
Growth hormone (GH) is involved in the regulation of the postnatal dental and skeletal growth, but its effects on oral health have not been clearly defined. This paper aims to provide a review of current clinical knowledge of dental caries, tooth wear, developmental enamel defects, craniofacial growth and morphology, dental maturation, and tooth eruption in growth hormone deficient (GHD) children. A systematic review was carried out using Scopus, MEDLINE-EbscoHost and Web of Science from 2000 to May 2021. PRISMA guidelines for reporting systematic reviews were followed. All the selected studies involved groups under eighteen years of age, covering a total of 465 GHD patients. The studies that were selected provide reliable evidence for delayed dental maturity and orthodontic disturbances in GHD patients. Data on dental hard tissues pathology are scarce and are limited to occurrences of dental caries. GHD children showed abnormal craniofacial morphology with reduced mandibular dimensions, with a resulting tendency towards Angle's Class II occlusion, which affected up to 31% of patients. Dental age has been shown to be delayed in GHD patients by about 1 to 2 years. Moreover, the risk of dental caries in children with GHD decreases with increasing levels of vitamin D. Hence, further studies would be valuable for evaluating the risk of various oral health problems and to organize targeted dental care for this vulnerable group.
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Affiliation(s)
- Natalia Torlińska-Walkowiak
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
| | - Katarzyna Anna Majewska
- Department of Clinical Auxology and Pediatric Nursing, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland; (K.A.M.); (A.K.)
| | - Andrzej Kędzia
- Department of Clinical Auxology and Pediatric Nursing, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland; (K.A.M.); (A.K.)
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
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Yang LL, Liang SS. Study on pathogenic genes of dwarfism disease by next-generation sequencing. World J Clin Cases 2021; 9:1600-1609. [PMID: 33728303 PMCID: PMC7942040 DOI: 10.12998/wjcc.v9.i7.1600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/10/2020] [Accepted: 12/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are many factors that lead to dwarfism, and the mechanism has not yet been elucidated. Next-generation sequencing may identify candidate-related gene mutations, which may clarify the molecular cause.
AIM To analyze genetic variation by using a constructed panel related to dwarfism by utilizing next-generation sequencing platform sequencing analysis to screen candidate-related gene mutations.
METHODS Physical and laboratory characteristics, including clinical examination, growth hormone drug challenge test, serum insulin-like growth factor-1 (IGF-1), IGF binding protein 3, other related tests, imaging examination, and chromosome karyotyping, were analyzed. Next-generation sequencing was performed to analyze pathogenicity variability.
RESULTS In the 39 dwarfism patients, 10 had pathogenicity variability. Gene variation was found in the OBSL1, SLC26A2, PTPN11, COL27AI, HDAC6, CUL7, FGFR3, DYNC2H1, GH1, and ATP7B genes. Of the 10 patients with pathogenicity variability, the related physical characteristics included double breast development and growth hormone deficiency, enuresis and indirect inguinal hernia on the left, two finger distance of 70.2 cm, head circumference of 49.2 cm, ischium/lower body length of 1.8 cm, weak limb muscles, and partial growth hormone deficiency. After 6 mo of growth hormone therapy, the concentrations of IGF-1 and IGF binding protein 3 increased from 215.2 ± 170.3 to 285.0 ± 166.0 and 3.9 ± 1.4 to 4.2 ± 1.1, respectively.
CONCLUSION OBSL1, SLC26A2, PTPN11, COL27AI, HDAC6, CUL7, FGFR3, DYNC2H1, GH1, and ATP7B genes may be related to the incidence of dwarfism, and more research needs to be performed to elucidate the mechanism.
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Affiliation(s)
- Lv-Lv Yang
- Department of Pediatrics, Quanzhou First Hospital, Quanzhou 362000, Fujian Province, China
| | - Shi-Shan Liang
- Department of Pediatrics, Quanzhou First Hospital, Quanzhou 362000, Fujian Province, China
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Sun M, Yan W, Zhao Q, Ji B, Ban B, Zhang M. Association Between Serum Calcium and Phosphorus Levels and Insulin-Like Growth Factor-1 in Chinese Children and Adolescents with Short Stature. Int J Gen Med 2020; 13:1167-1173. [PMID: 33244257 PMCID: PMC7683825 DOI: 10.2147/ijgm.s276261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The aim of this study was to investigate the effect of serum calcium and phosphorus levels on the insulin-like growth factor 1 (IGF-1) in Chinese children and adolescents with short stature. Methods In this cross-sectional analysis, the clinical data of 747 children with height below –2 SD who were evaluated at the Department of Endocrinology, Affiliated Hospital of Jining Medical University from March 1, 2013, to February 28, 2019, were selected. Anthropometric and biochemical indicators were measured. The relationship between the serum calcium and phosphorus levels and IGF-1 was analysed. Results The univariate analysis results showed that serum calcium or phosphorus was significantly associated with IGF-1 SDS. In addition, after adjusting for possible confounding factors, a linear relationship between serum calcium and IGF-1 SDS and a non-linear relationship between serum phosphorus and IGF-1 SDS were observed by smooth curve fitting. The results of the fully adjusted linear regression showed that serum calcium was positively associated with IGF-1 SDS (β 1.07, 95% CI 0.21, 1.92; p = 0.015). In the multivariate piecewise linear regression, when the serum phosphorus level was greater than 1.26 mmol/L, the IGF-1 SDS increased with the increase in serum phosphorus (β 1.92, 95% CI 1.36, 2.48; p < 0.001). However, we did not observe a significant relationship when the serum phosphorus level was less than 1.26 mmol/L (p = 0.223). Conclusion This study demonstrated that in Chinese children and adolescents with short stature, circulating calcium and phosphorus concentrations may be associated with the regulation of IGF-1 levels, and this relationship merits further investigation.
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Affiliation(s)
- Minghui Sun
- Department of Clinical Medicine, Jining Medical University, Jining, Shandong 272067, People's Republic of China
| | - Wenhua Yan
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, People's Republic of China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong 272029, People's Republic of China
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