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Xavier CB, Dassie-Leite AP, Pereira RM, Nesi-França S, De Lacerda L. Vocal Characteristics of Children With Short Stature Before and After Growth Hormone Treatment. J Voice 2024; 38:968.e9-968.e17. [PMID: 35090764 DOI: 10.1016/j.jvoice.2022.01.004] [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: 10/21/2021] [Revised: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the vocal characteristics of children with short stature before and 12 months after growth hormone treatment. MATERIAL AND METHODS This analytical, observational cohort study included 23 children (age 5-11 years) diagnosed with short stature. Children in the short stature group (SSG) were matched (1:1) for age and sex with children with normal growth (normal stature group; NSG). Participants in the SSG underwent assessments before and 12 months after growth hormone treatment, while those in the NSG underwent the same assessments at baseline and 12 months. The assessments included evaluation of (A) vocal characteristics (history, vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis), (B) anthropometry, (C) bone age, and (D) measurement of insulin-like growth factor-1 (IGF-1) levels. RESULTS Children in the SSG had more vocal complaints (P = 0.026) than those in the NSG. The groups were similar in terms of vocal self-assessment and auditory-perceptual evaluation (P = nonsignificant). Results of acoustic analysis were also similar for fundamental frequency (F 0) and perturbation measures (P for both = nonsignificant). F 0 and speech frequency decreased significantly at 12 months in both groups. F1 values were higher at 12 months in the NSG, while F2 values were significantly higher in the baseline evaluation in boys in the SSG. Children in the SSG compared with those in the NSG presented a greater increase in height measurements at 12 months, although the anthropometric means were lower in both evaluations (P < 0.001). CONCLUSION Vocal characteristics in children with short stature before and after treatment with growth hormone are comparable to those in children with normal growth.
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Affiliation(s)
- Congeta Bruniera Xavier
- Postgraduate Program of Childhood and Adolescence Health, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Ana Paula Dassie-Leite
- Department of Speech-Language Pathology, Universidade Estadual do Centro-Oeste, Irati, Paraná, Brazil
| | - Rosana Marques Pereira
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Suzana Nesi-França
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Luiz De Lacerda
- Division of Pediatric Endocrinology, Department of Pediatrics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Bal KK, Alagoz S, Delibas V, Ortoglu F, Ceylan B, Ozdas T, Kuran G, Gorgulu O. Effects of Infertility on Voice in male patients. Indian J Otolaryngol Head Neck Surg 2022; 74:5199-5206. [PMID: 36742516 PMCID: PMC9895568 DOI: 10.1007/s12070-022-03130-0] [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: 11/28/2021] [Accepted: 07/10/2022] [Indexed: 02/07/2023] Open
Abstract
Purpose In this study, we aimed to determine the differences in normospermic, oligospermic and azoospermic infertile men by performing voice analysis and to discuss this in the light of the literature. Methods 71 male patients who applied to the urology clinic due to infertility and were then referred to us were included in the study. Hormone analysis and spermiogram were requested from the patients for routine infertility tests. Testosterone, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin levels of the patients were recorded. Age and spermiogram results were recorded. According to the spermiogram results, the patients were categorized as Group 1 (azoospermic), Group 2 (oligospermic), Group 3 (normospermic). Voice Handicap Index-10 Turkish version (VHI-10) was applied to the patients and the results were recorded. Results The age of the infertile patients ranged from 20 to 37. The mean age was 28.23. The distribution of the patients was 21 patients in Group 1, 40 patients in Group 2, and 10 patients in Group 3. The mean Testosterone level of the patients was 2.78; mean FSH level 12.14; mean LH level 7.26; mean Prolactin level was 8.1. The mean VHI-10 scores of the patients were 10.52. The fundamental frequency F0 Hz (mean pitch) values of the patients were 176,468; jitter % (frequency perturbation jitter) values average 0.25; shimmer % (amplitude perturbation shimmer) values average 2,322; HNR dB values averaged 24,862. Conclusions Testosterone is more effective on the voice, especially in male individuals.It would be more logical to think that many hormones, growth factors and local factors are effective instead of a single hormone.
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Affiliation(s)
- Kemal Koray Bal
- Otorhinolaryngology Department,Lecturer Otorhinolaryngology Specialist, University of Mersin, Mersin, Turkey
| | - Sedat Alagoz
- Otorhinolaryngology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Vedat Delibas
- Otorhinolaryngology Department,Research Assistant Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Ferhat Ortoglu
- Urology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Betul Ceylan
- Speech and Language Therapist, Otorhinolaryngology Department, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Talih Ozdas
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Gokhan Kuran
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Orhan Gorgulu
- Otorhinolaryngology Department,Professor , Ozel Adana Ortadogu Hospital, Adana, Turkey
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Aguiar-Oliveira MH, Salvatori R. The state of Sergipe contribution to GH research: from Souza Leite to Itabaianinha syndrome. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:919-928. [PMID: 36394485 PMCID: PMC10118753 DOI: 10.20945/2359-3997000000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the late 19th century, José Dantas de Souza Leite, a physician born in Sergipe, published the first detailed clinical description of acromegaly under the guidance of the French neurologist Pierre Marie. In 2014, the Brazilian Society of Endocrinology and Metabolism created the "José Dantas de Souza Leite Award", which is granted every two years to a Brazilian researcher who has contributed to the development of endocrinology. In 2022, the award was given to another physician from Sergipe, Manuel Hermínio de Aguiar Oliveira, from the Federal University of Sergipe for the description of "Itabaianinha syndrome" in a cohort of individuals with isolated GH deficiency due to a homozygous inactivating mutation in the GH-releasing hormone receptor gene. This research, which was carried out over almost 30 years, was performed in partnership with Roberto Salvatori from Johns Hopkins University and in collaboration with other researchers around the world. This review article tells the story of Souza Leite, some milestones in the history of GH, and summarizes the description of Itabaianinha syndrome.
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de Andrade BMR, Valença EHO, Salvatori R, Oliveira LA, Souza AHO, Oliveira AHA, Oliveira MCP, Melo EV, de Carvalho S, Sales NJ, Monteiro GC, de Lima JM, Annunziato MFH, Mannis GDB, de A Souza LE, Goes YD, Carvalho TS, de Farias C, Dos Santos MP, Cardoso GPF, Pereira Sousa CS, Santana JR, Sales EA, d'Avila JS, Aguiar-Oliveira MH. Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:198-205. [PMID: 35315986 PMCID: PMC9832885 DOI: 10.20945/2359-3997000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves "short long-lived people", rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Methods Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusion Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.
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Affiliation(s)
- Bruna M R de Andrade
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Eugenia H O Valença
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore (Maryland), United States
| | - Luiz A Oliveira
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Anita H O Souza
- Divisão de Endocrinologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Alaíde H A Oliveira
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Mario C P Oliveira
- Departamento de Comunicação Social, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Enaldo V Melo
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Susana de Carvalho
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Neuza J Sales
- Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | | | | | | | | | - Lucas E de A Souza
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Yasmin D Goes
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Thayza S Carvalho
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Celiane de Farias
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Michela P Dos Santos
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Gabriela P F Cardoso
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Carla S Pereira Sousa
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Julia Rodrigues Santana
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Ester Almeida Sales
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Jeferson Sampaio d'Avila
- Divisão de Otorrinolaringologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Manuel H Aguiar-Oliveira
- Divisão de Endocrinologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil,
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Girão RS, Aguiar-Oliveira MH, Andrade BMR, Bittencourt MAV, Salvatori R, Silva EV, Santos ALM, Cunha MM, Takeshita WM, Oliveira AHA, Valença EHO, Oliveira-Santos AA, Oliveira-Neto LA. Dental arches in inherited severe isolated growth hormone deficiency. Growth Horm IGF Res 2022; 62:101444. [PMID: 35151933 DOI: 10.1016/j.ghir.2022.101444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The growth of the dental arches depends on GH and insulin-like growth factor type 1 (IGF1), but the consequences of GH deficiency (GHD) on their growth are still unclear, probably due to the acquired etiology of GHD in most described series, often associated with additional pituitary deficits (thyrotrophic, corticotrophic and gonadotrophic hormones), and imperfections of related replacement therapies, which may affect the dental arch growth. To avoid these limitations, we took advantage of a unique cohort of subjects with isolated GH deficiency (IGHD) due the same mutation in the GH releasing hormone receptor gene, living with very low serum GH and low to undetectable circulating IGF1 levels. Our purpose was to analyze the dimensions of maxillary and mandibular dental arches. METHODS 22 adult IGHD (15 untreated and 7 previously partially treated with GH) and 33 controls were enrolled in a cross-sectional study using the Ortho Insight 3D and MeshMixer software, RESULTS: In untreated IGHD subjects all maxillary arch measures were smaller than controls, while among mandibular arches, only the mandibular canine width and the mandibular arch length were reduced. In partially GH treated subjects only the palate depth, the maxillary canine width, the maxillary and mandibular arch lengths remained smaller than controls. CONCLUSIONS IGHD reduces the growth of maxillary arch to a greater degree than the mandibular arch, suggesting different control of superior and inferior dental arches. GH treatment increases some of these measures.
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Affiliation(s)
- Rafaela S Girão
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
| | - Bruna M R Andrade
- Division of Speech therapy, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Evânio V Silva
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - André L M Santos
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Matheus M Cunha
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Wilton M Takeshita
- Postgraduate Program in Dentistry School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alaíde H A Oliveira
- School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Eugênia H O Valença
- Division of Speech therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alécia A Oliveira-Santos
- Division of Nutrition, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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6
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Aguiar-Oliveira MH, Salvatori R. Disruption of the GHRH receptor and its impact on children and adults: The Itabaianinha syndrome. Rev Endocr Metab Disord 2021; 22:81-89. [PMID: 32935264 DOI: 10.1007/s11154-020-09591-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/22/2022]
Abstract
Since 1994, we have been studying an extended kindred with 105 subjects (over 8 generations) residing in Itabaianinha County, in the Brazilian state of Sergipe, who have severe isolated GH deficiency (IGHD) due to a homozygous inactivating mutation (c.57 + 1G > A) in the GH releasing hormone (GHRH) receptor (GHRHR) gene. Most of these individuals have never received GH replacement therapy. They have low GH, and very low and often undetectable levels of serum IGF-I. Their principal physical findings are proportionate short stature, doll facies, high-pitched-voice, central obesity, wrinkled skin, and youthful hair with delayed pigmentation, and virtual absence of graying. The newborns from this cohort are of normal size, indicating that GH is not needed for intra-uterine growth. However, these IGHD individuals exhibit a myriad of phenotypic changes throughout the body, with a greater number of beneficial than harmful consequences. This GHRH signal disruption syndrome has been a valuable model to study the GH roles in body size and function. This reviews summarized the findings we have reported on this cohort.
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Affiliation(s)
- Manuel H Aguiar-Oliveira
- Division of Endocrinology, University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, Aracaju, Sergipe, 49060-100, Brazil.
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore, Baltimore, MD, 21287, USA
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Lopes LW, França FP, Evangelista DDS, Alves JDN, Vieira VJD, de Lima-Silva MFB, Pernambuco LDA. Does the Combination of Glottal and Supraglottic Acoustic Measures Improve Discrimination Between Women With and Without Voice Disorders? J Voice 2020; 36:583.e17-583.e29. [PMID: 32917459 DOI: 10.1016/j.jvoice.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/28/2022]
Abstract
AIM To analyze the accuracy of traditional acoustic measurements (F0, perturbation, and noise) and formant measurements in discriminating between women with and without voice disorders, and with different laryngeal disorders. STUDY DESIGN A descriptive, cross-sectional, and retrospective. METHOD Two hundred and sixty women participated. All participants recorded the spoken vowel /Ɛ/ and underwent laryngeal visual examination. Acoustic measures of the mean and standard deviation of the fundamental frequency (F0), jitter, shimmer, glottal-to-noise excitation ratio, and the values of the first three formants (F1, F2, and F3) were obtained. RESULTS Individual acoustic measurements did not demonstrate adequate (<70%) performance when discriminating between women with and without voice disorders. The combination of the standard deviation of the F0, shimmer, glottal-to-noise excitation ratio, F1, F2, and F3 showed acceptable (>70%) performance in classifying women with and without voice disorders. Individual measures of jitter as well as F1 and F3 demonstrated acceptable (>70%) performance when distinguishing women with different laryngeal diagnoses, including without voice disorders (healthy larynges), Reinke's edema, unilateral vocal fold paralysis, and sulcus vocalis. The combination of acoustic measurements showed excellent (>80%) performance when discriminating women without voice disorder from those with Reinke's edema (mean of F0, F1, and F3) and with sulcus vocalis (mean of F0, F1, and F2). CONCLUSIONS Individual formant and traditional acoustic measurements do not demonstrate adequate performance when discriminating between women with and without voice disorders. However, the combination of traditional and formant measurements improves the discrimination between the presence and absence of voice disorders and differentiates several laryngeal diagnoses.
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Affiliation(s)
- Leonardo Wanderley Lopes
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil.
| | - Fernanda Pereira França
- Ph.D Candidate of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Deyverson da Silva Evangelista
- Ph.D Candidate of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Jônatas do Nascimento Alves
- Master degree of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Vinícius Jefferson Dias Vieira
- Post doctorate researcher in the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Maria Fabiana Bonfim de Lima-Silva
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Leandro de Araújo Pernambuco
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
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Reinheimer DM, Andrade BMR, Nascimento JKF, Fonte JBM, Araújo IMP, Martins-Filho PRS, Salvatori R, Valença EHO, Oliveira AHA, Aguiar-Oliveira MH, Oliveira-Neto LA. Formant Frequencies, Cephalometric Measures, and Pharyngeal Airway Width in Adults With Congenital, Isolated, and Untreated Growth Hormone Deficiency. J Voice 2019; 35:61-68. [PMID: 31147205 DOI: 10.1016/j.jvoice.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/23/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Adult subjects with isolated growth hormone deficiency (IGHD) due to a mutation in the growth hormone releasing hormone receptor gene exhibit higher values formant frequencies. In normal subjects, a significant negative association between the formant frequencies and the reduction of linear craniofacial measurements, especially of maxilla and mandible, has been reported. This suggests smaller pharyngeal width, despite low prevalence of obstructive sleep apnea syndrome. Here we evaluate their pharyngeal airway width, its correlation with vowel formant frequencies, and the correlation between them and the craniofacial measures. SUBJECTS AND METHODS A two-step protocol was performed. In the first case-control experiment, aimed to assess the pharyngeal width, we compared nine adult IGHD and 36 normal statured controls. Both upper and lower pharyngeal widths were measured. The second step (assessment of pharyngeal width) was performed only in the IGHD group. RESULTS Upper and lower pharyngeal widths were similar in IGHD and controls. In IGHD subjects, the lower pharyngeal width exhibited a negative correlation with F1 [a] and a positive correlation with mandibular length. There were negative correlations between F1 and F2 with linear and positive correlations with the angular measures. CONCLUSIONS Pharyngeal airway width is not reduced in adults with congenital, untreated lifetime IGHD, contributing to the low prevalence of obstructive sleep apnea syndrome. The formant frequencies relate more with cephalometric measurements than with the pharyngeal airway width. These findings exemplify the consequences of lifetime IGHD on osseous and nonosseous growth.
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Affiliation(s)
- Daniele M Reinheimer
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - Bruna M R Andrade
- Division of Speech Therapy, Federal University of Sergipe, Aracaju, Brazil
| | | | - Juliana B M Fonte
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - Isabella M P Araújo
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Alaíde H A Oliveira
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | | | - Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
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9
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Aguiar-Oliveira MH, Bartke A. Growth Hormone Deficiency: Health and Longevity. Endocr Rev 2019; 40:575-601. [PMID: 30576428 PMCID: PMC6416709 DOI: 10.1210/er.2018-00216] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Abstract
The important role of GH in the control of mammalian longevity was first deduced from extended longevity of mice with genetic GH deficiency (GHD) or GH resistance. Mice with isolated GHD (IGHD) due to GHRH or GHRH receptor mutations, combined deficiency of GH, prolactin, and TSH, or global deletion of GH receptors live longer than do their normal siblings. They also exhibit multiple features of delayed and/or slower aging, accompanied by extension of healthspan. The unexpected, remarkable longevity benefit of severe endocrine defects in these animals presumably represents evolutionarily conserved trade-offs among aging, growth, maturation, fecundity, and the underlying anabolic processes. Importantly, the negative association of GH signaling with longevity extends to other mammalian species, apparently including humans. Data obtained in humans with IGHD type 1B, owing to a mutation of the GHRH receptor gene, in the Itabaianinha County, Brazil, provide a unique opportunity to study the impact of severe reduction in GH signaling on age-related characteristics, health, and functionality. Individuals with IGHD are characterized by proportional short stature, doll facies, high-pitched voices, and central obesity. They have delayed puberty but are fertile and generally healthy. Moreover, these IGHD individuals are partially protected from cancer and some of the common effects of aging and can attain extreme longevity, 103 years of age in one case. We think that low, but detectable, residual GH secretion combined with life-long reduction of circulating IGF-1 and with some tissue levels of IGF-1 and/or IGF-2 preserved may account for the normal longevity and apparent extension of healthspan in these individuals.
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Affiliation(s)
| | - Andrzej Bartke
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois
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de Andrade BMR, Valença EHO, Salvatori R, Souza AHO, Oliveira-Neto LA, Oliveira AHA, Oliveira MCP, Melo EV, Andrade MS, Freitas CA, Santos MP, Custodio FA, Monteiro GC, de Carvalho S, Aguiar-Oliveira MH. Effects of Therapy With Semi-occluded Vocal Tract and Choir Training on Voice in Adult Individuals With Congenital, Isolated, Untreated Growth Hormone Deficiency. J Voice 2018; 33:808.e1-808.e5. [PMID: 29567051 DOI: 10.1016/j.jvoice.2018.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/21/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Voice is produced by the vibration of the vocal folds expressed by its fundamental frequency (Hz), whereas the formants (F) are fundamental frequency multiples, indicating amplification zones of the vowels in the vocal tract. We have shown that lifetime isolated growth hormone deficiency (IGHD) causes high pitch voice, with higher values of most formant frequencies, maintaining a prepuberal acoustic prediction. The objectives of this work were to verify the effects of the therapy with a semi-occluded vocal tract (SOVTT) and choir training on voice in these subjects with IGHD. We speculated that acoustic vocal parameters can be improved by SOVTT or choir training. STUDY DESIGN This is a prospective longitudinal study without control group. METHODS Acoustic analysis of isolated vowels was performed in 17 adults with IGHD before and after SOVTT (pre-SOVTT and post-SOVTT) and after choir training (post training), in a 30-day period. RESULTS The first formant was higher in post training compared with the pre-SOVTT (P = 0.009). The second formant was higher in post-SOVTT than in pre-SOVTT (P = 0.045). There was a trend of reduction in shimmer in post-choir training in comparison with pre-SOVTT (P = 0.051), and a reduction in post-choir training in comparison with post-SOVTT (P = 0.047). CONCLUSIONS SOVTT was relevant to the second formant, whereas choir training improved first formant and shimmer. Therefore, this speech therapy approach was able to improve acoustic parameters of the voice of individuals with congenital, untreated IGHD. This seems particularly important in a scenario in which few patients are submitted to growth hormone replacement therapy.
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Affiliation(s)
- Bruna M R de Andrade
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Eugenia H O Valença
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anita H O Souza
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Alaíde H A Oliveira
- Division of Dentistry, Federal University of Sergipe, Aracaju, Sergipe Brazil
| | - Mario C P Oliveira
- Department of Social Communication, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Enaldo V Melo
- Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Michelle S Andrade
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Carolina A Freitas
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Michela P Santos
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Fillipe A Custodio
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Gisane C Monteiro
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Susana de Carvalho
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Aguiar-Oliveira MH, Davalos C, Campos VC, Oliveira Neto LA, Marinho CG, Oliveira CRP. Hypothalamic abnormalities: Growth failure due to defects of the GHRH receptor. Growth Horm IGF Res 2018; 38:14-18. [PMID: 29277338 DOI: 10.1016/j.ghir.2017.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 12/16/2022]
Abstract
Several acquired or congenital hypothalamic abnormalities may cause growth failure (GF). We described two of these congenital abnormalities. First, a case of CHARGE syndrome, an epigenetic disorder mostly caused by heterozygous mutations in the gene encoding CHD7, a chromatin remodeling protein, causing several malformations, some life-threatening, with additional secondary hypothalamus-hypophyseal dysfunction, including GF. Second, a cohort of individuals with genetic isolated severe GH deficiency (IGHD), due to a homozygous mutation in the GH-releasing hormone (GHRH) receptor gene described in Itabaianinha County, in northeast Brazil. In this IGHD, with marked reduction of serum concentrations of IGF-I, and an up regulation of IGF-II, GF is the principal finding in otherwise normal subjects, with normal quality of life and longevity. This IGHD may unveil the effects of GHRH, pituitary GH and IGF-I, IGF-II and local GH and growth factor on the size and function of body and several systems. For instance, anterior pituitary hypoplasia, and impairment of the non-REM sleep may be due to GHRH resistance. Proportionate short stature, doll facies, high-pitched pre-pubertal voice, and reduced muscle mass reflect the lack of the synergistic effect of pituitary GH and IGF-I in bones and muscles. Central adiposity may be due to a direct effect of the lack of GH. Brain, eyes and immune system may also involve IGF-II and local GH or growth factors. A concept of physiological hierarchy controlling body size and function by each component of the GH system may be drawn from this model.
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Affiliation(s)
- Manuel H Aguiar-Oliveira
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil.
| | - Caridad Davalos
- Division of Pediatrics, Pediatric Critical Care, Hospital Pediatrico Baca Ortiz, Universidad San Francisco de Quito, 1712-841 Quito, Ecuador
| | - Viviane C Campos
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Luiz A Oliveira Neto
- Department of Orthodontics, School of Dentistry, Federal University of Sergipe, 49060-100 Aracaju, Sergipe, Brazil
| | - Cindi G Marinho
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
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Abstract
Voice is one of the advanced features of natural evolution that differentiates human beings from other primates. The human voice is capable of conveying the thoughts into spoken words along with a subtle emotion to the tone. This extraordinary character of the voice in expressing multiple emotions is the gift of God to the human beings and helps in effective interpersonal communication. Voice generation involves close interaction between cerebral signals and the peripheral apparatus consisting of the larynx, vocal cords, and trachea. The human voice is susceptible to the hormonal changes throughout life right from the puberty until senescence. Thyroid, gonadal and growth hormones have tremendous impact on the structure and function of the vocal apparatus. The alteration of voice is observed even in physiological states such as puberty and menstruation. Astute clinical observers make out the changes in the voice and refer the patients for endocrine evaluation. In this review, we shall discuss the hormonal influence on the voice apparatus in normal and endocrine disorders.
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Affiliation(s)
- K. V. S. Hari Kumar
- Department of Endocrinology, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Anurag Garg
- Department of Anesthesiology, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - N. S. Ajai Chandra
- Department of Anesthesiology, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - S. P. Singh
- Department of ENT, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Rakesh Datta
- Department of ENT, Command Hospital, Chandimandir, Panchkula, Haryana, India
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XUE YING, GAO YIQING, WANG SHUQIN, WANG PEI. An examination of the effects of different doses of recombinant human growth hormone on children with growth hormone deficiency. Exp Ther Med 2016; 11:1647-1652. [PMID: 27168784 PMCID: PMC4840766 DOI: 10.3892/etm.2016.3091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 02/19/2016] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study was to examine the effects of different doses of recombinant human growth hormone (rhGH) on children with growth hormone deficiency (GHD) and on thyroid and glucose metabolism to identify more reasonable therapeutic doses of growth hormone (GH) for the treatment of this condition. In total, 60 prepubertal patients with GHD were randomly divided into the high-dose and low-dose groups (n=30 per group). The groups were treated with 0.1 or 0.05 U/kg for 6 months, respectively. The follow-up study focused on changes to the serum levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein (IGFBP)-3, blood glucose, thyroid hormone [triiodothyronine (T3) and its prohormone, thyroxine (T4), and thyroid stimulating hormone (TSH)] and the analysis of variance of the repeated data. Changes in the height, body weight and bone age of the high-dose group were greater than those of the low-dose group. After 6 months of treatment, the difference in height between the two groups was statistically significant (P<0.05). Glucose metabolism in the two groups was consistent, but there was a statistically significant difference in the fasting blood glucose (FBG) levels of the two groups after 6 months of treatment (P<0.05). Prior to treatment, the T3, T4 and TSH values (the thyroid function tests) in the two groups, especially for the value of T3 in high-dose group were varied. However, 6 months after treatment, statistically significant differences between the two groups (P<0.05) were identified. In conclusion, 0.1 U/kg of GH is beneficial to children with GHD in attaining a satisfactory height, but it leads to insulin resistance. Thus, glucose metabolism and thyroid function should be monitored on a regular basis in a clinical setting.
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Affiliation(s)
- YING XUE
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - YIQING GAO
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - SHUQIN WANG
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - PEI WANG
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
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