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Jackmann N, Gustafsson J, Utriainen P, Magnusson P, Harila A, Atanasova D, Rinaldo C, Frisk P, Mäkitie O. Demographic and disease-related factors impact bone turnover and vitamin D in children with hemato-oncological diseases. JBMR Plus 2024; 8:ziae017. [PMID: 38523666 PMCID: PMC10961176 DOI: 10.1093/jbmrpl/ziae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Children with hemato-oncological diseases may have significant skeletal morbidity, not only during and after treatment but also at the time of diagnosis before cancer treatment. This study was designed to evaluate the vitamin D status and circulating bone metabolic markers and their determinants in children at the time of diagnostic evaluation for hemato-oncological disease. This cross-sectional study included 165 children (91 males, median age 6.9 yr range 0.2-17.7 yr). Of them, 76 patients were diagnosed with extracranial or intracranial solid tumors, 83 with leukemia, and 6 with bone marrow failure. Bone metabolism was assessed by measuring serum 25OHD, PTH, bone alkaline phosphatase, intact N-terminal propeptide of type I procollagen, and C-terminal cross-linked telopeptide of type I collagen. Vitamin D deficiency was found in 30.9% of children. Lower 25OHD levels were associated with older age, lack of vitamin D supplementation, season outside summer, and a country of parental origin located between latitudes -45° and 45°. Children diagnosed with leukemia had lower levels of markers of bone formation and bone resorption than those who had solid tumors or bone marrow failure. In conclusion, vitamin D deficiency was observed in one-third of children with newly diagnosed cancer. Bone turnover markers were decreased in children with leukemia, possibly because of the suppression of osteoblasts and osteoclasts by leukemic cells. The identification of patients with suboptimal vitamin D status and compromised bone remodeling at cancer diagnosis may aid in the development of supportive treatment to reduce the adverse effects of cancer and its treatment.
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Affiliation(s)
- Natalja Jackmann
- Department of Women’s and Children’s Health, Uppsala University and University Children’s Hospital, Uppsala 75185, Sweden
| | - Jan Gustafsson
- Department of Women’s and Children’s Health, Uppsala University and University Children’s Hospital, Uppsala 75185, Sweden
| | - Pauliina Utriainen
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki 00014, Finland
| | - Per Magnusson
- Department of Clinical Chemistry, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58183, Sweden
| | - Arja Harila
- Department of Women’s and Children’s Health, Uppsala University and University Children’s Hospital, Uppsala 75185, Sweden
| | - Diana Atanasova
- Department of Clinical Chemistry, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58183, Sweden
| | - Carina Rinaldo
- Department of Women's and Children's Health, Karolinska Institute, Stockholm 17177, Sweden
| | - Per Frisk
- Department of Women’s and Children’s Health, Uppsala University and University Children’s Hospital, Uppsala 75185, Sweden
| | - Outi Mäkitie
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki 00014, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, and Clinical Genetics, Karolinska University Hospital, Stockholm 17177, Sweden
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Maghnie M, Orso M, Polistena B, Cappa M, Pozzobon G, d'Angela D, Patti G, Spandonaro F, Granato S, Di Virgilio R, La Torre D, Salerno M. Quality of life in children and adolescents with growth hormone deficiency and their caregivers: an Italian survey. J Endocrinol Invest 2023; 46:2513-2523. [PMID: 37209402 PMCID: PMC10632207 DOI: 10.1007/s40618-023-02106-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/30/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE The aim of this study was to produce evidence on quality of life (QoL) among Italian growth hormone deficiency (GHD) children and adolescents treated with growth hormone (GH) and their parents. METHODS A survey was conducted among Italian children and adolescents aged 4-18 with a confirmed diagnosis of GHD and treated with GH therapy and their parents. The European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) and the Quality of Life in Short Stature Youth (QoLISSY) questionnaires were administered between May and October 2021 through the Computer-Assisted Personal Interview (CAPI) method. Results were compared with national and international reference values. RESULTS The survey included 142 GHD children/adolescents and their parents. The mean EQ-5D-3L score was 0.95 [standard deviation (SD) 0.09], while the mean visual analogue scale (VAS) score was 86.2 (SD 14.2); the scores are similar to those of a reference Italian population aged 18-24 of healthy subjects. As for the QoLISSY child-version, compared to the international reference values for GHD/ idiopathic short stature (ISS) patients, we found a significantly higher score for the physical domain, and lower scores for coping and treatment; compared to the specific reference values for GHD patients, our mean scores were significantly lower for all domains except the physical one. As for the parents, we found a significantly higher score for the physical domain, and a lower score for treatment; compared to reference values GHD-specific, we found lower score in the social, emotional, treatment, parental effects, and total score domains. CONCLUSIONS Our results suggest that the generic health-related quality of life (HRQoL) in treated GHD patients is high, comparable to that of healthy people. The QoL elicited by a disease specific questionnaire is also good, and comparable with that of international reference values of GHD/ISS patients.
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Affiliation(s)
- M Maghnie
- Paediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - M Orso
- C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy.
| | - B Polistena
- C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy
- University of Rome Tor Vergata, Rome, Italy
| | - M Cappa
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Pozzobon
- Pediatric Clinic, IRCCS San Raffaele Hospital, Università Vita-Salute San Raffaele, Milan, Italy
| | - D d'Angela
- C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy
- University of Rome Tor Vergata, Rome, Italy
| | - G Patti
- Paediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - F Spandonaro
- C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy
- San Raffaele University, Rome, Italy
| | - S Granato
- Medical Department, Pfizer Italia, Rome, Italy
| | | | - D La Torre
- Global Medical Affairs, Pfizer Rare Disease, Rome, Italy
| | - M Salerno
- Department of Translational Medical Sciences, Paediatric Endocrinology Unit, University of Naples 'Federico II', Naples, Italy
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Holzapfel L, Choukair D, Schenk JP, Bettendorf M. Longitudinal assessment of bone health index as a measure of bone health in short-statured children before and during treatment with recombinant growth hormone. J Pediatr Endocrinol Metab 2023; 36:824-831. [PMID: 37531076 DOI: 10.1515/jpem-2023-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES The aim of our study was the longitudinal assessment of bone health index (BHI) in short-statured children during growth hormone (GH) treatment to estimate changes in their bone health. METHODS 256 short-statured children (isolated GH deficiency (IGHD) n=121, multiple pituitary hormone deficiency (MPHD) n=49, intrauterine growth retardation (small for gestational age (SGA)) n=52, SHOX (short stature homeobox gene) deficiency n=9, Ullrich Turner syndrome (UTS) n=25) who started with GH between 2010 and 2018 were included. Annual bone ages (Greulich and Pyle, GP) and BHI were, retrospectively, analysed in consecutive radiographs of the left hand (BoneXpert software) from GH therapy start (T0) up to 10 years (T10) thereafter, with T max indicating the individual time point of the last available radiograph. The results are presented as the median (25 %/75 % interquartile ranges, IQR) and statistical analyses were performed using non-parametric tests as appropriate. RESULTS The BHI standard deviation scores (SDS) were reduced (-0.97, -1.8/-0.3) as bone ages were retarded (-1.6 years, -2.31/-0.97) in all patients before start of GH and were significantly lower in patients with growth hormone deficiency (GHD) (-1.04, -1.85/-0.56; n=170) compared to non-GHD patients (-0.79, -1.56/-0.01; n=86; p=0.022). BHI SDS increased to -0.17 (-1/0.58) after 1 year of GH (T1, 0.5-1.49, p<0.001) and to -0.20 (-1/-0.50, p<0.001) after 5.3 years (T max, 3.45/7.25). CONCLUSIONS BHI SDS are reduced in treatment-naive short-statured children regardless of their GH status, increase initially with GH treatment while plateauing thereafter, suggesting sustained improved bone health.
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Affiliation(s)
- Lukas Holzapfel
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Daniela Choukair
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Jens-Peter Schenk
- Division of Paediatric Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Bettendorf
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University Hospital Heidelberg, Heidelberg, Germany
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4
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Wydra A, Czajka-Oraniec I, Wydra J, Zgliczyński W. The influence of growth hormone deficiency on bone health and metabolisms. Reumatologia 2023; 61:239-247. [PMID: 37745147 PMCID: PMC10515129 DOI: 10.5114/reum/170244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/01/2023] [Indexed: 09/26/2023] Open
Abstract
Growth hormone (GH) is a key peptide hormone in the regulation of bone metabolism, through its systemic and paracrine action mediated directly as well as by insulin-like growth factor-1 (IGF-1). Growth hormone exerts pleiotropic effects leading to an increase in linear bone growth, accumulation of bone mineral content and preservation of peak bone mass. Furthermore, it influences protein, lipid, and carbohydrate metabolism.Growth hormone deficiency (GHD) causes a low bone turnover rate leading to reduced bone mineral density (BMD) and increased bone fragility. The results of GH insufficiency are the most pronounced among children as it negatively affects longitudinal bone growth, causing short stature and in adolescents, in whom it hinders the acquisition of peak bone mass. Most studies show that treatment with recombinant human growth hormone (rhGH) in GHD patients could improve BMD and decrease fracture risk. This review aims to summarize the pathophysiology, clinical picture and management of bone complications observed in GHD.
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Affiliation(s)
- Arnika Wydra
- Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
| | - Izabella Czajka-Oraniec
- Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
| | - Jakub Wydra
- Department of Internal Medicine, Bielanski Hospital, Warsaw, Poland
| | - Wojciech Zgliczyński
- Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
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Abstract
The foundation of bone health is established in utero. Bone accrual starts from the developing fetus and continues throughout childhood and adolescence. This process is crucial to achieve peak bone mass. Understanding factors that influence bone accrual before attainment of peak bone mass is thus critical to improve bone health and prevent osteoporosis, thereby reducing the burden of osteoporotic fractures in older women. In this review, we broadly outline factors influencing peak bone mass from pregnancy to infancy, childhood and adolescence with potential diseases and medications that may affect the optimum trajectory to maximizing bone health. It is estimated that a 10% increase in peak bone mass will delay the onset of osteoporosis by 13 years in a woman.
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Affiliation(s)
- R F Vasanwala
- KK Women's and Children's Hospital, Singapore, Singapore
| | - L Gani
- Changi General Hospital, Singapore, Singapore
| | - S B Ang
- KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
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Yoon JS, Seo YJ, Kwon EB, Lee HJ, Kang MJ, Hwang IT. Association between uric acid and height during growth hormone therapy in children with idiopathic short stature. Front Endocrinol (Lausanne) 2022; 13:1025005. [PMID: 36531458 PMCID: PMC9755161 DOI: 10.3389/fendo.2022.1025005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Serum uric acid (UA) within appropriate levels is reported to be beneficial in patients with idiopathic short stature (ISS). This study aimed to evaluate the association between serum UA levels and height standard deviation scores (SDS) in patients with ISS during growth hormone (GH) therapy. METHODS A longitudinal study (LG Growth Study) of 182 children (mean age: 7.29±2.60 years) with ISS was performed. All participants were in the prepubertal stage and treated with GH, and the data within a treatment period of 30 months were analyzed. RESULTS In the adjusted Pearson's correlation, UA was significantly correlated with height SDS after controlling for sex, age, and body mass index (BMI) SDS (r=0.22, p=0.007). In the adjusted multiple regression analyses, the height SDS was significantly associated with UA after controlling for sex, age, and BMI SDS (β=0.168, p=0.007). Within the 30-month treatment period, the UA levels significantly increased as the height SDS increased, and the mean UA levels at baseline and 30 months after treatment were 3.90±0.64 mg/dL and 4.71±0.77 mg/dL, respectively (p=0.007). DISCUSSION In conclusion, UA is related to height SDS, and GH treatment leads to a significant increase in UA without hyperuricemia. Elevated UA is considered a favorable outcome of GH therapy, and further studies are needed to determine its role as a monitoring tool.
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7
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Yang G, Yang Q, Li Y, Zhang Y, Chen S, He D, Zhang M, Ban B, Liu F. Association Between the Growth Hormone/Insulin-Like Growth Factor-1 Axis and Muscle Density in Children and Adolescents of Short Stature. Front Endocrinol (Lausanne) 2022; 13:920200. [PMID: 35774144 PMCID: PMC9238351 DOI: 10.3389/fendo.2022.920200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To evaluate the association between the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and muscle density in children and adolescents of short stature. METHODS Participants were children and adolescents of short stature hospitalized in the Affiliated Hospital of Jining Medical University between January 2020 and June 2021. All participants had CT scan images available. We performed an analysis of the images to calculate the muscle density or skeletal muscle attenuation (SMA), skeletal muscle index (SMI), and fat mass index (FMI). Bioelectrical impedance analysis (BIA) was used to ensure that chest CT is a credible way of evaluating body composition. RESULTS A total of 297 subjects were included with the mean age of 10.00 ± 3.42 years, mean height standard deviation score (SDS) of -2.51 ± 0.53, and mean IGF-1 SDS of -0.60 ± 1.07. The areas of muscle and fat tissues at the fourth thoracic vertebra level in the CT images showed strong correlation with the total weights of the participants (R2 = 0.884 and 0.897, respectively). The peak of GH was negatively associated with FMI (r = - 0.323, P <.01) and IGF-1 SDS was positively associated with SMI (r = 0.303, P <.01). Both the peak GH and IGF-1 SDS were positively associated with SMA (r = 0.244, P <.01 and r = 0.165, P <.05, respectively). Multiple stepwise linear regression analysis demonstrated that the GH peak was the predictor of FMI (β = - 0.210, P < .01), the IGF-1 SDS was the predictor of SMI (β = 0.224, P < .01), and both the peak GH and IGF-1 SDS were predictors of SMA (β = 0.180, P < .01 and β = 0.222, P < .01). CONCLUSIONS A chest CT scan is a credible method of evaluating body composition in children and adolescents of short stature. In these patients, peak GH and IGF-1 SDS are independent predictors of muscle density and the GF/IGF-1 axis may regulate body composition through complex mechanisms.
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Affiliation(s)
- Guangzhi Yang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Qing Yang
- Department of Nutrition, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yanying Li
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yanhong Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Shuxiong Chen
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Dongye He
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
- *Correspondence: Fupeng Liu, ; Bo Ban,
| | - Fupeng Liu
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
- *Correspondence: Fupeng Liu, ; Bo Ban,
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O’Neil J, Fuqua JS. Short stature and the effect of human growth hormone: Guidelines for the care of people with spina bifida. J Pediatr Rehabil Med 2021; 13:549-555. [PMID: 32986629 PMCID: PMC7838964 DOI: 10.3233/prm-200710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
It is estimated that a significant percentage of individuals with spina bifida (SB) are shorter than their age-matched typical peers. Parents of children with spina bifida may ask if human growth hormone is appropriate for their child. This article discusses short stature and the use of human growth hormone among children with SB. This guideline was developed for SB Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida.
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Affiliation(s)
- Joseph O’Neil
- Riley Hospital for Children, Section of Developmental Pediatrics, Indianapolis, IN, USA
| | - John S. Fuqua
- Riley Hospital for Children, Section of Pediatric Endocrinology, Indianapolis, IN, USA
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Yoon SH, Grynpas MD, Mitchell J. Growth Hormone Increases Bone Toughness and Decreases Muscle Inflammation in Glucocorticoid-Treated Mdx Mice, Model of Duchenne Muscular Dystrophy. J Bone Miner Res 2019; 34:1473-1486. [PMID: 31188496 DOI: 10.1002/jbmr.3718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 01/03/2023]
Abstract
The absence of functional dystrophin with mutations of the dystrophin-encoding gene in Duchenne muscular dystrophy (DMD) results in muscle inflammation and degeneration, as well as bone fragility. Long-term glucocorticoid therapy delays the muscular disease progression but suppresses growth hormone secretion, resulting in short stature and further deleterious effects on bone strength. This study evaluated the therapeutic potential of daily growth hormone therapy in growing mdx mice as a model of DMD. Growth hormone treatment on its own or in combination with glucocorticoids significantly improved muscle histology and function and decreased markers of inflammation in mdx mice. Glucocorticoid treatment thinned cortical bone and decreased bone strength and toughness. Despite the minimal effects of growth hormone on bone microarchitecture, it significantly improved biomechanical properties of femurs and vertebrae, even in the presence of glucocorticoid treatment. Together these studies suggest that the use of growth hormone in DMD should be considered for improvements to muscle and bone health. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sung-Hee Yoon
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Health System, Toronto, Canada
| | - Marc D Grynpas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Health System, Toronto, Canada
| | - Jane Mitchell
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
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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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11
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Capalbo D, Barbieri F, Improda N, Giallauria F, Di Pietro E, Rapacciuolo A, Di Mase R, Vigorito C, Salerno M. Growth Hormone Improves Cardiopulmonary Capacity and Body Composition in Children With Growth Hormone Deficiency. J Clin Endocrinol Metab 2017; 102:4080-4088. [PMID: 28938456 DOI: 10.1210/jc.2017-00871] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/24/2017] [Indexed: 01/22/2023]
Abstract
CONTEXT Growth hormone deficiency (GHD) in children may be associated with early cardiovascular risk factors and alterations in left ventricular (LV) structure and function; data on cardiopulmonary functional capacity are lacking. OBJECTIVES Aim of the study was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiopulmonary functional capacity, left and right cardiac structure and function, and body composition in children and adolescents. DESIGN Prospective, case-control study. PATIENTS AND METHODS Twenty-one untrained GHD children (11.3 ± 0.8 years) underwent cardiopulmonary exercise testing, echocardiography and dual-energy x-ray absorptiometry, before and after 12 months of GH therapy. Twenty-one controls matched for sex, pubertal status, body mass index, and physical activity (PA) were evaluated at baseline and after 1 year. RESULTS At baseline, GHD patients showed reduced LV mass (LVM; 63.32 ± 7.80 vs 80.44 ± 26.29 g/m2, P = 0.006), peak oxygen consumption (VO2peak; 22.92 ± 4.80 vs 27.48 ± 6.71 mL/Kg/min, P = 0.02), peak workload (80.62 ± 29.32 vs 103.76 ± 36.20 W, P = 0.02), and O2 pulse (4.93 ± 1.30 vs 7.67 ± 2.93 mL/beat, P = 0.0003), compared with controls. GHD patients also exhibited lower lean body mass (LBM 65.36 ± 7.84% vs 76.13 ± 8.23%, P < 0.001), and higher fat mass (FM 30.84 ± 7.92% vs 22.19 ± 8.18%, P = 0.001) than controls. GH therapy resulted in a significant increase of LVM (72.01 ± 15.88, P = 0.03), VO2peak (26.80 ± 4.97; P = 0.01), peak workload (103.67 ± 32.24, P = 0.001), O2 pulse (6.64 ± 1.68, P = 0.0007), and LBM (75.36 ± 7.59%, P = 0.0001), with a reduction in FM (22.62 ± 7.73%, P = 0.001). No difference was found in either left or right ventricular function. CONCLUSION Our results suggest that cardiac structure, body composition and cardiopulmonary functional capacity are impaired in children with untreated GHD and can be restored after short-term GH replacement therapy.
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Affiliation(s)
- Donatella Capalbo
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, 80131 Naples, Italy
| | - Flavia Barbieri
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, 80131 Naples, Italy
| | - Nicola Improda
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, 80131 Naples, Italy
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, Federico II University of Naples, 80131 Naples, Italy
| | - Elisa Di Pietro
- Department of Advanced Biomedical Science, Federico II University of Naples, 80131 Naples, Italy
| | - Antonio Rapacciuolo
- Department of Advanced Biomedical Science, Federico II University of Naples, 80131 Naples, Italy
| | - Raffaella Di Mase
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, 80131 Naples, Italy
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, Federico II University of Naples, 80131 Naples, Italy
| | - Mariacarolina Salerno
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, 80131 Naples, Italy
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Davidopoulou S, Chatzigianni A. Craniofacial morphology and dental maturity in children with reduced somatic growth of different aetiology and the effect of growth hormone treatment. Prog Orthod 2017; 18:10. [PMID: 28447324 PMCID: PMC5406315 DOI: 10.1186/s40510-017-0164-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/07/2017] [Indexed: 01/08/2023] Open
Abstract
Children with reduced somatic growth may present various endocrinal diseases, especially growth hormone deficiency (GHD), idiopathic short stature (ISS), chromosomal aberrations, or genetic disorders. In an attempt to normalize the short stature, growth hormone (GH) is administered to these children. The aim of this literature review was to collect information about the craniofacial morphology and dental maturity in these children and to present the existing knowledge on the effect of GH treatment on the above structures. This review demonstrated that regardless of the origin of the somatic growth retardation, these children show similar craniofacial features, such as short length of the cranial base and the mandible, increased lower facial height, retropositioned mandible, and obtuse gonion angle. On the other hand, dental maturation does not demonstrate a specific pattern. Except for the above findings, muscle alterations seem to be present in individuals with short stature, who present low body muscle mass and strength, while studies on their craniofacial muscles seem to be lacking. After GH administration, the exact amount and pattern of craniofacial growth is unpredictable; however, the facial convexity decreases, mandibular length increases, and posterior facial height increases, while tooth eruption remains unaffected. Thus, it is of great importance to gain more insight into the craniofacial growth of treated and untreated children with reduced somatic growth so that the influence of GH therapy on the various craniofacial structures could be ascertained and proper orthodontic treatment could be selected.
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Affiliation(s)
- Sotiria Davidopoulou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
| | - Athina Chatzigianni
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
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13
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Pelosi P, Lapi E, Cavalli L, Verrotti A, Pantaleo M, de Martino M, Stagi S. Bone Status in a Patient with Insulin-Like Growth Factor-1 Receptor Deletion Syndrome: Bone Quality and Structure Evaluation Using Dual-Energy X-Ray Absorptiometry, Peripheral Quantitative Computed Tomography, and Quantitative Ultrasonography. Front Endocrinol (Lausanne) 2017; 8:227. [PMID: 28936199 PMCID: PMC5595156 DOI: 10.3389/fendo.2017.00227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 08/21/2017] [Indexed: 01/02/2023] Open
Abstract
Haploinsufficiency of the insulin-like growth factor (IGF)-1 receptor (IGF1R) gene is a rare, probably under-diagnosed, cause of short stature. However, the effects of IGF1R haploinsufficiency on glucose metabolism, bone status, and metabolism have rarely been investigated. We report the case of a patient referred to our center at the age of 18 months for short stature, failure to thrive, and Silver-Russell-like phenotype. Genetic analysis did not show hypomethylation of the 11p15.5 region or uniparental disomy of chromosome 7. Growth hormone (GH) stimulation tests revealed GH deficiency, whereas IGF-1 was 248 ng/mL. r-hGH treatment showed only a slight improvement (from -4.4 to -3.5 SDS). At 10 years of age, the child was re-evaluated: CGH-array identified a heterozygous de novo 4.92 Mb deletion in 15q26.2, including the IGF1R gene. Dual-energy X-ray absorptiometry showed a normal bone mineral density z-score, while peripheral quantitative computed tomography revealed reduced cortical and increased trabecular elements. A phalangeal bone quantitative ultrasonography showed significantly reduced amplitude-dependent speed of sound and bone transmission time values. The changes in bone architecture, quality, and metabolism in heterozygous IGF1R deletion patients, support the hypothesis that IGF-1 can be a key factor in bone modeling and accrual.
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Affiliation(s)
- Paola Pelosi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Elisabetta Lapi
- Genetics and Molecular Medicine Unit, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Loredana Cavalli
- Department of Neuroscience, Neurorehabilitation Section, University of Pisa, Pisa, Italy
| | - Alberto Verrotti
- Department of Paediatrics, University of L’Aquila, L’Aquila, Italy
| | - Marilena Pantaleo
- Genetics and Molecular Medicine Unit, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Stefano Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
- *Correspondence: Stefano Stagi,
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