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Andrade-Guimarães AL, Aguiar-Oliveira MH, Salvatori R, Carvalho VO, Alvim-Pereira F, Daniel CRA, Brasileiro GAM, Santana-Ribeiro AA, Santos-Carvalho HA, Oliveira CRP, Vieira ER, Gois-Junior MB. Adult individuals with congenital, untreated, severe isolated growth hormone deficiency have satisfactory muscular function. Endocrine 2019; 63:112-119. [PMID: 30251164 DOI: 10.1007/s12020-018-1763-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE While growth hormone (GH) and the insulin-like growth factor type I (IGF-I) are known to exert synergistic actions on muscle anabolism, the consequences of prolonged GH deficiency (GHD) on muscle function have not been well defined. We have previously described a large cohort of subjects with isolated GHD (IGHD) caused by a mutation in the GH-releasing hormone receptor gene, with low serum levels of GH and IGF-I. The aim of this study was to assess muscular function in these IGHD subjects. METHODS A total of 31 GH-naïve IGHD (16 males) and 40 control (20 males) subjects, matched by age and degree of daily physical activity, were enrolled. Fat free mass was measured by bioelectrical impedance; muscle strength by dynamometry of handgrip, trunk extension, and knee extension; myoelectric activity and muscle fatigue by fractal dimension; conduction velocity in vastus medialis, rectus femoris, and vastus lateralis muscles by surface electromyography. RESULTS The IGHD group showed higher knee extension strength both when corrected for weight and fat free mass, and higher handgrip and trunk extension strength corrected by fat free mass. They also exhibit higher conduction velocity of the muscles vastus medialis, rectus femoris, and vastus lateralis, but lower free fat mass and myoelectric activity of the vastus medialis, rectus femoris and vastus lateralis. There were no differences between the two groups in fractal dimension in all studied muscles. CONCLUSION Individuals with untreated IGHD have better muscle strength parameters adjusted for weight and fat free mass than controls. They also exhibit greater peripheral resistance to fatigue, demonstrating satisfactory muscle function.
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Affiliation(s)
- Alana L Andrade-Guimarães
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, 21287, USA.
| | - Vitor O Carvalho
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Fabiano Alvim-Pereira
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carlos R Araújo Daniel
- Department of Statistic and Actuarial Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Giulliani A Moreira Brasileiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Ananda A Santana-Ribeiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Hugo A Santos-Carvalho
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Edgar R Vieira
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
| | - Miburge B Gois-Junior
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
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Ahmid M, Ahmed SF, Shaikh MG. Childhood-onset growth hormone deficiency and the transition to adulthood: current perspective. Ther Clin Risk Manag 2018; 14:2283-2291. [PMID: 30538484 PMCID: PMC6260189 DOI: 10.2147/tcrm.s136576] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Childhood-onset growth hormone deficiency (CO-GHD) is an endocrine condition associated with a broad range of health issues from childhood through to adulthood, which requires particular attention during the transition period from adolescence to young adulthood. There is uncertainty in the clinical practice of the management of CO-GHD during transition regarding the clinical assessment and management of individual patients during and after transition to obtain optimal follow-up and improved health outcomes. Despite the availability of clinical guidelines providing the framework for transition of young adults with CO-GHD, there remains substantial variation in approaching transitional care among pediatric and adult services. A well-structured and coordinated transitional plan with clear communication and direct collaboration between pediatric and adult health care to ensure optimal management of adolescents with CO-GHD during transition is needed.
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Affiliation(s)
- M Ahmid
- Development Endocrinology Research Group, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK,
| | - S F Ahmed
- Development Endocrinology Research Group, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK,
| | - M G Shaikh
- Development Endocrinology Research Group, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK,
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Impaired muscle strength may contribute to fatigue in patients with aneurysmal subarachnoid hemorrhage. Int J Rehabil Res 2017; 40:29-36. [PMID: 27741020 DOI: 10.1097/mrr.0000000000000197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with aneurysmal subarachnoid hemorrhage (a-SAH) show long-term fatigue and face difficulties in resuming daily physical activities. Impaired muscle strength, especially of the lower extremity, impacts the performance of daily activities and may trigger the onset of fatigue complaints. The present study evaluated knee muscle strength and fatigue in patients with a-SAH. This study included 33 patients, 6 months after a-SAH, and 33 sex-matched and age-matched healthy controls. Isokinetic muscle strength of the knee extensors and flexors was measured at 60 and 180°/s. Maximal voluntary muscle strength was defined as peak torque and measured in Newton-meter. Fatigue was examined using the Fatigue Severity Scale. In patients with a-SAH, the maximal knee extension was 22% (60°/s) and 25% (180°/s) lower and maximal knee flexion was 33% (60°/s) and 36% (180°/s) lower compared with that of matched controls (P≤0.001). The Fatigue Severity Scale score was related to maximal knee extension (60°/s: r=-0.426, P=0.015; 180°/s: r=-0.376, P=0.034) and flexion (60°/s: r=-0.482, P=0.005; 180°/s: r=-0.344, P=0.083). The knee muscle strength was 28-47% lower in fatigued (n=13) and 11-32% lower in nonfatigued (n=20) patients; deficits were larger in fatigued patients (P<0.05), particularly when the muscle strength (peak torque) was measured at 60°/s. The present results indicate that patients with a-SAH have considerably impaired knee muscle strength, which is related to more severe fatigue. The present findings are exploratory, but showed that knee muscle strength may play a role in the severity of fatigue complaints, or vice versa. Interventions targeting fatigue after a-SAH seem necessary and may consider strengthening exercise training in order to treat a debilitating condition.
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Loftus J, Heatley R, Walsh C, Dimitri P. Systematic review of the clinical effectiveness of Genotropin (somatropin) in children with short stature. J Pediatr Endocrinol Metab 2010; 23:535-51. [PMID: 20662327 DOI: 10.1515/jpem.2010.092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Genotropin (somatropin) is licensed for the treatment of children with growth hormone deficiency, Prader-Willi syndrome, Turner syndrome, chronic renal insufficiency and in children born small for gestational age. This systematic review (SR) evaluated the clinical efficacy and effectiveness of Genotropin in these conditions to inform a NICE Technology Appraisal of growth hormone for the treatment of growth failure in children. Search terms were used to search seven databases, including Medline and Embase, for English language studies. Randomised controlled trials (RCTs) or observational studies investigating Genotropin in children were included. Out of 30 RCTs identified, one reported final height data. Eleven observational studies reported final height and seven were based on the Pfizer International Growth Survey (KIGS). This SR highlights the lack of long-term RCTs reporting final height data and other important qualitative outcomes, such as quality of life. Observational data, such as those from KIGS, remain vital for informing therapy.
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