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Barbato A, Vergatti A, Giaquinto A, Pizzulo IL, Perna L, Perruolo G, Abate V, Sibilio M, Mainolfi C, Soscia E, De Filippo G, Formisano P, Galletti F, Strazzullo P, Rendina D. Imiglucerase, cholecalciferol, and bone-diet in skeletal health management of type I Gaucher disease patients: a pilot study and systematic review. JBMR Plus 2024; 8:ziae071. [PMID: 39006867 PMCID: PMC11245647 DOI: 10.1093/jbmrpl/ziae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/03/2024] [Accepted: 05/23/2024] [Indexed: 07/16/2024] Open
Abstract
Skeletal anomalies represent a characteristic feature of type 1 Gaucher disease (GD1). Here we evaluated the impact of an integrated therapy comprising enzyme-replacement therapy (ERT), cholecalciferol, and a normocalcemic-normocaloric-hyposodic diet (bone diet) on bone health in GD1 patients. We also performed a systematic review to compare our results with available data. From January 1, 2015 to February 28, 2019, all GD1 patients referred to Federico II University were enrolled and treated with the integrated therapy. Bone turnover markers and bone mineral density (BMD) were evaluated at baseline (T0) and after 24 months (T24). We enrolled 25 GD1 patients, all showing 25-hydroxy vitamin D (25OHD) levels < 50 nmol/l (hypovitaminosis D) at T0. Response to cholecalciferol treatment was effective, showing a direct relationship between 25OHD levels before and after treatment. At T0, 2 GD1 patients showed fragility fractures, 5 the Erlenmeyer flask deformity, 3 osteonecrosis, and 7 a BMD Z-score ≤ -2. Overall, GD1 patients with bone anomalies showed higher C-terminal telopeptide levels compared with those without bone anomalies. No new bone anomalies occurred during 2 years of follow-up. At T24, BMD remained stable across the entire study cohort, including in patients with bone anomalies. The systematic review showed that our study is the first that evaluated all bone health parameters. Hypovitaminosis D is prevalent in GD1 patients. The response to cholecalciferol treatment was effective but different to healthy subjects and in patients with metabolic bone disorders. Integrated therapy including ERT, cholecalciferol, and bone diet guarantees bone health.
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Affiliation(s)
- Antonio Barbato
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Anita Vergatti
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Alfonso Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Ilaria Libera Pizzulo
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Ludovica Perna
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Giuseppe Perruolo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Michelina Sibilio
- Metabolic Diseases Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy
| | - Ciro Mainolfi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Ernesto Soscia
- Institute of Biostructures and Bioimaging of the National Research Council – CNR, 80131 Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d’Endocrinologie-Diabétologie, 75019 Paris, France
| | - Pietro Formisano
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Pasquale Strazzullo
- Former Professor of Internal Medicine, Federico II University, 80131 Naples, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
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Jang S, Park S, Lee B. Key elements of Korean medicine treatment for idiopathic short-stature: A qualitative SWOT analysis based on Korean medicine doctors' views. Medicine (Baltimore) 2024; 103:e39116. [PMID: 39058864 PMCID: PMC11272295 DOI: 10.1097/md.0000000000039116] [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: 03/21/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
The objective of this study was to explore the key elements of Korean medicine (KM) treatment for idiopathic short stature (ISS) by analyzing the strengths, weaknesses, opportunities, and threats (SWOT). This was a qualitative study of interviews with 7 KM doctors who had at least 3 years of experience in KM treatment for ISS. Based on the content, a SWOT and a cross-SWOT analysis were conducted. A SWOT of KM treatment for ISS was derived as follows: Strengths included the additional positive health promotion effects and fewer possibilities of adverse effects. Weaknesses included insufficient long-term evidence on the effect and safety and difficulty in predicting prognosis for ISS treatment in KM. Opportunities included a growing interest in height growth in general and the need for parental involvement in children height growth. Threats included the limited use of diagnostic devices and relatively high medical costs due to non-coverage by national health insurance. This study suggests that the safety and clinical effectiveness evidence of KM treatment for height growth should be guaranteed through well-designed large-scale long-term studies. Various strategies are needed to promote the use of diagnostic and evaluation devices for ISS treatment in KM clinical settings.
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Affiliation(s)
- Soobin Jang
- Department of Preventive Medicine, College of Korean Medicine, Daegu Haany University, Gyeongsan, Republic of Korea
| | - Seokyung Park
- Department of Education & Research, Seoul Korean Medicine Hospital of Daejeon University, Seoul, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Fang D, Li X, Zhang Z, Cai H, Wang L, Yu J, Hu X, Ye B. Clinical profiles and molecular genetic analyses of 98 Chinese children with short statures. Front Genet 2024; 15:1364441. [PMID: 38933926 PMCID: PMC11199712 DOI: 10.3389/fgene.2024.1364441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/29/2024] [Indexed: 06/28/2024] Open
Abstract
Background Short stature is one of the most prevalent endocrine disorders in children, and its genetic basis is a complex and actively researched subject. Currently, there is limited genetic research on exome sequencing for short stature, and more large-scale studies are necessary for further exploration. Methods The retrospective study entailed investigation of 98 Chinese children with short statures (height SDS ≤ -2.5) of unknown etiologies recruited between 2017 and 2021. Whole-exome sequencing (WES) was performed on these patients to identify the potential genetic etiologies. The clinical data were reviewed retrospectively to assess the pathogenicity of the identified mutations. Additionally, 31 patients consented to and received recombinant human growth hormone (rhGH) therapy for 12 months. The short-term effects of rhGH treatment were evaluated across different etiologies of patients with short statures. Results The WES results were used to identify 31 different variants in 18 genes among 24 (24.5%) patients. Individuals with more severe short statures were more likely to have underlying genetic etiologies. Short stature accompanied by other phenotypes had significantly higher diagnostic yields than simple severe short stature. The rhGH therapy demonstrated efficacy in most children. Nevertheless, the treatment response was suboptimal in a boy diagnosed with 3M syndrome. Conclusion WES is an important approach for confirming genetic disorders in patients with severe short statures of unknown etiologies, suggesting that it could be used as a primary diagnostic strategy. The administration of rhGH may not be suitable for all children with short statures, and the identification of the genetic cause of short stature by WES has significant guidance value for rhGH treatment.
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Affiliation(s)
- Danfeng Fang
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Xing Li
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Zhigang Zhang
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Hefei Cai
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Lu Wang
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Jiahe Yu
- Department of Pediatric Endocrinology/Genetics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuanye Hu
- Department of Pediatric Endocrinology/Genetics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Ye
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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Alhumaidi KA, Alotaibi EA, Almansour S, Alharbi A, Alharbi NH, AlJameli SM, Aljateli GA, Alobaid NM, Almasoud RA. Parents' Knowledge and Perception Toward Short Stature in Saudi Arabia. Cureus 2023; 15:e51163. [PMID: 38283450 PMCID: PMC10812849 DOI: 10.7759/cureus.51163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Short stature is a common reason for referral to pediatric endocrinologists. A Saudi study highlights significant short stature prevalence, with parents exhibiting varied knowledge levels. Common normal variants of short stature are familial short stature, constitutional, and idiopathic short stature. Pathologic causes of short stature include growth hormone deficiency, genetic disorders, and chronic diseases. Parents' knowledge plays an important role in the diagnosis and early intervention of this condition. Insufficient studies prompt the authors to conduct a novel survey assessing Saudi parents' knowledge and perceptions of short stature, filling a research gap. Methodology This is a cross-sectional study conducted among Saudi Parents in five different regions of Saudi Arabia. A self-administered questionnaire was distributed among parents via an online survey. The questionnaire includes sociodemographic characteristics and questions to assess the knowledge and perception regarding short stature. Non-probability sampling targets parents living in Saudi Arabia. Data is analyzed by SPSS version 29 (IBM Inc., Armonk, New York). Results Our study on Saudi parents' knowledge of short stature reveals diverse awareness levels. While genetic causes are widely recognized in (71.6%; N=245) of parents (N=352), awareness drops for factors like low birth weight (23.9%; N=82) total of (N=352). Parents show uncertainty in recognizing short stature (51.4%; N=352) and varied beliefs on growth cessation. A majority (65.6%; N=231) of parents (N=352) prefer early intervention, with 41.5% (N=146) of parents (N=352) recognizing growth hormone therapy. Sociodemographic factors influence knowledge scores, with higher scores in males (21.03) and Central region residents (22.03; p<0.001). Notably, 83.4% (N=248) of parents (N=352) acknowledge psychological complications. Conclusion Our study highlights varied awareness among parents regarding short stature, emphasizing genetic causes but demonstrating gaps in recognizing certain factors. Sociodemographic factors significantly influence knowledge scores. Psychological complications are widely acknowledged.
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Affiliation(s)
- Kadi A Alhumaidi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Eman A Alotaibi
- Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | | | - Aeshah Alharbi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Norah H Alharbi
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Shahad M AlJameli
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Ghadah A Aljateli
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
| | - Njood M Alobaid
- Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, SAU
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Wang S, Wu Z, Chen Y, Luo K, Cui Z, Zhang J, Zheng J, Xiao K, Li H. Comparative efficacy of aromatase inhibitors and gonadotropin-releasing hormone analogue in increasing final height of idiopathic short stature boys: a network meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1167351. [PMID: 37124748 PMCID: PMC10140494 DOI: 10.3389/fendo.2023.1167351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Objective To investigate the efficacy of monotherapy with AIs or GnRHa in improving the height of boys with idiopathic short stature (ISS). Method We performed a systematic search in Pubmed, The Cochrane Library, Chinese National Knowledge Infrastructure databases, and Wanfang Database for eligible studies. The network meta-analysis was conducted using STATA software. Results We identified a total of four studies that included 136 individuals. We used FAH/PAH as the main outcome of final height. The results revealed a statistically higher final height after treatment with AI or GnRHa in idiopathic short stature children(MD= 4.63, 95% CI[3.29,5.96]). In network meta-analysis, the direct and indirect comparison between AI and GnRHa was presented in the forest plot. Compared with control group, both AI and GnRHa were effective in increasing the final height, with the mean effect of 4.91(95%CI:1.10,8.17) and 5.55(95%CI:1.12,9.98) respectively. However, there was no statistical difference between the GnRHa and AI treatment, of which the mean effect was 0.65(95%CI: -4.30,5.60). Conclusion Both AIs and GnRHa monotherapy were effective in augmenting the final height of boys with idiopathic short stature when compared to placebo groups. However, there was no statistical difference between the GnRHa and AI treatments.
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Affiliation(s)
| | | | | | | | | | | | | | - Kangli Xiao
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huiqing Li
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Bunyan DJ, Hobbs JI, Duncan-Flavell PJ, Howarth RJ, Beal S, Baralle D, Thomas NS. SHOX Whole Gene Duplications Are Overrepresented in SHOX Haploinsufficiency Phenotype Cohorts. Cytogenet Genome Res 2023; 162:587-598. [PMID: 36927524 DOI: 10.1159/000530171] [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: 12/19/2022] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Transcription of SHOX is dependent upon the interaction of the gene with a complex array of flanking regulatory elements. Duplications that contain flanking regulatory elements but not the SHOX gene have been reported in individuals with SHOX haploinsufficiency syndromes, suggesting that alterations to the physical organisation or genomic architecture may affect SHOX transcription. Individuals with tall stature and an additional X or Y chromosome have an extra copy of both the SHOX gene and the entire SHOX regulatory region, so all three copies of SHOX can be expressed fully. However, for a duplication of the SHOX gene that does not include all of the flanking regulatory elements, the potential effect on SHOX expression is difficult to predict. We present nine unpublished individuals with a SHOX whole gene duplication in whom the duplication contains variable amounts of the SHOX regulatory region, and we review 29 similar cases from the literature where phenotypic data were clearly stated. While tall stature was present in a proportion of these cases, we present evidence that SHOX whole gene duplications can also result in a phenotype more typically associated with SHOX haploinsufficiency and are significantly overrepresented in Leri-Weill dyschondrosteosis and idiopathic short stature probands compared to population controls. Although similar-looking duplications do not always produce a consistent phenotype, there may be potential genotype-phenotype correlations regarding the duplication size, regulatory element content, and the breakpoint proximity to the SHOX gene. Although ClinGen does not currently consider SHOX whole gene duplications to be clinically significant, the ClinGen triplosensitivity score does not take into account the context of the duplication, and more is now known about SHOX duplications and the role of flanking elements in SHOX regulation. The evidence presented here suggests that these duplications should not be discounted without considering the extent of the duplication and the patient phenotype, and should be included in diagnostic laboratory reports as variants of uncertain significance. Given the uncertain pathogenicity of these duplications, any reports should encourage the exclusion of all other causes of short stature where possible.
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Affiliation(s)
- David J Bunyan
- Wessex Genomics Laboratory Service, Salisbury District Hospital, Salisbury, UK
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - James I Hobbs
- Wessex Genomics Laboratory Service, Salisbury District Hospital, Salisbury, UK
| | | | - Rachel J Howarth
- Wessex Genomics Laboratory Service, Salisbury District Hospital, Salisbury, UK
| | - Sarah Beal
- Wessex Genomics Laboratory Service, Salisbury District Hospital, Salisbury, UK
| | - Diana Baralle
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas Simon Thomas
- Wessex Genomics Laboratory Service, Salisbury District Hospital, Salisbury, UK
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Jang S, Lee SH, Kim YJ, Lee B. Cost-effectiveness analysis of herbal medicines in children with idiopathic short stature. Medicine (Baltimore) 2023; 102:e33193. [PMID: 36897666 PMCID: PMC9997761 DOI: 10.1097/md.0000000000033193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/14/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Herbal medicines have been used for a long time to treat idiopathic short stature (ISS) in children in East Asian countries. The aim of this study was to analyze the cost-effectiveness of 5 herbal medicines frequently used in clinical settings for children with ISS based on medical records. METHODS Patients with ISS who had been prescribed a 60-day supply of herbal medicines in 1 Korean medicine hospital were included in this analysis. Their height and height percentile were measured before and after treatment within 6-months. The average cost-effectiveness ratios (ACERs) of 5 herbal medicines for height (cm) and height percentile were calculated for boys and girls, respectively. RESULTS The ACERs per 1 cm height growth were USD 56.2 (Naesohwajung-Tang), USD 74.8 (Ogapi-Growth decoction), USD 86.6 (Gamcho-Growth decoction), USD 94.6 (Gwakhyangjeonggi-San plus Yukmijihwang-Tang), and USD 113.8 (Boyang-Growth decoction). The ACERs per 1 percentile height growth were USD 205 (Naesohwajung-Tang), USD 293 (Ogapi-Growth decoction), USD 470 (Gamcho-Growth decoction), USD 949 (Boyang-Growth decoction), and USD 1051 (Gwakhyangjeonggi-San plus Yukmijihwang-Tang). CONCLUSION Herbal medicine might be a potential economical alternative treatment for ISS.
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Affiliation(s)
- Soobin Jang
- Department of Preventive Medicine, College of Korean Medicine, Daegu Haany University, Gyeongsangbuk-do, Republic of Korea
| | - Sun Haeng Lee
- Department of Korean Pediatrics, College of Korean Medicine Kyung Hee University, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Ye Ji Kim
- Department of Korean Pediatrics, College of Korean Medicine Kyung Hee University, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Mouskou S, Leka-Emiri S, Korona A, Mastroyanni S, Manolakos E, Papoulidis I, Sekouris N, Katerelos A, Katsarou-Pectasides E, Voudris K. Growth Hormone Deficiency due to p.(Gln467Argfs*64) Mutation in the ARID1B Gene in a Girl with Coffin-Siris Syndrome. Mol Syndromol 2022; 13:425-432. [PMID: 36588753 PMCID: PMC9801320 DOI: 10.1159/000522532] [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: 02/23/2021] [Accepted: 02/09/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Coffin-Siris syndrome (CSS) (MIM #135900) is an extremely rare genetic multisystemic disorder characterized by aplasia or hypoplasia of the upper phalanx of the fifth finger, moderate to severe cognitive and/or developmental delay, and characteristic facial features (thick lashes, hypertrichosis of the trunk, sparse hair). Congenital anomalies of the brain, kidney, and heart have been described but are less consistent across patients. Case presentation We report a case of a 12-year-5-month-old girl with the clinical features of CSS, severe scoliosis, and epilepsy. Growth hormone deficiency was diagnosed at the age of 9 years. Recombinant human growth hormone (rhGH) treatment was started that resulted in a significant improvement of the growth velocity up to 5.4 cm/year (>90-97th centile). Next-generation sequencing identified a mutation in the ARID1B gene. Discusion Despite its phenotypic heterogeneity, key features of CSS have become clearer and along with molecular diagnosis, a further global approach to improve the care of these individuals is enabled. Appropriate therapies for this population are needed to optimize growth and intellectual potentials.
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Affiliation(s)
- Stella Mouskou
- Department of Neurology, ‘P & A Kyriakou’ Children's Hospital, Athens, Greece,*Stella Mouskou,
| | - Sofia Leka-Emiri
- Department of Endocrinology-Growth and Development, ‘P & A Kyriakou’ Children's Hospital, Athens, Greece
| | - Anastasia Korona
- Department of Neurology, ‘P & A Kyriakou’ Children's Hospital, Athens, Greece
| | - Sotiria Mastroyanni
- Department of Neurology, ‘P & A Kyriakou’ Children's Hospital, Athens, Greece
| | | | | | - Nick Sekouris
- Department of Orthopedics, “KAT” General Hospital, Athens, Greece
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Wu Z, Yuan J, Li J, Du Z, Yin M, Cheng X, Liu X, Jia J. Hsa_circ_0008870 suppresses bone formation of growth plate through inhibition of miR-185-3p/ MAPK1 axis in idiopathic short stature. Front Bioeng Biotechnol 2022; 10:1022830. [PMID: 36304901 PMCID: PMC9592914 DOI: 10.3389/fbioe.2022.1022830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022] Open
Abstract
Idiopathic short stature (ISS) is the most common clinical cause of the short stature with an unclear aetiology and a lack of effective treatment. Circular RNAs have been shown to play a significant regulatory role through various signal transduction pathways in a variety of diseases in recent years. However, the role of circular RNAs on ISS is not yet well-understood and requires a special attention. The differentially expressed circular RNAs were screened by microarray chip analysis, and RT-qPCR was used to verify the expression of hsa_circ_0008870 in ISS patients. Subsequently, in vitro and in vivo experiments were conducted to determine the biological functions of hsa_circ_0008870 in ISS. The authors first confirmed that hsa_ circ_0008870 was downregulated in ISS children. Meanwhile, we also observed that the downregulated hsa_circ _0008870 significantly inhibited chondrocyte proliferation and endochondral ossification in vivo and in vitro. Mechanistically, hsa_circ_0008870 regulates MAPK1 expression by sponge miR-185-3p. This mechanism of action was further verified through rescue experiments. Finally, the authors revealed that the silencing of hsa_circ_0008870 induces low expression of MAPK1 by impairing the sponge action of miR-185-3p, thereby inhibiting chondrocyte proliferation, hypertrophy, and endochondral ossification, which results in a short stature phenotype. In addition to these, we also observed an interesting phenomenon that upregulated of miR-185-3p can in turn inhibit the expression of hsa_circ_0008870 in chondrocytes. This suggests that hsa_circ_0008870 could potentially serve as a therapeutic target for the treatment of ISS.
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Affiliation(s)
- Zhiwen Wu
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
| | - Jinghong Yuan
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
| | - Jiantian Li
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
| | - Zhi Du
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
| | - Ming Yin
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
| | - Xigao Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
| | - Xijuan Liu
- Department of Paediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Xijuan Liu, ; Jingyu Jia,
| | - Jingyu Jia
- Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Orthopedics of Jiangxi Province, Nanchang University, Nanchang, Jiangxi, China
- Institute of Minimally Invasive Orthopedics, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of Intervertebral Disc Disease, Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Xijuan Liu, ; Jingyu Jia,
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Chae HW, Hwang IT, Lee JE, So CH, Rhie YJ, Lim JS, Kwon EB, Yi KH, Kim EY, Jo CK, Shim KS, Gil HY, Seong MJ, Nam CM, Moon JS, Hwang JS. Height outcomes in Korean children with idiopathic short stature receiving growth hormone treatment. Front Endocrinol (Lausanne) 2022; 13:925102. [PMID: 36157444 PMCID: PMC9490583 DOI: 10.3389/fendo.2022.925102] [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: 04/21/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Growth hormone (GH) therapy's capacity to increase height velocity and height at the end of the study in children with idiopathic short stature (ISS) is controversial. We aimed to investigate the height standard deviation score (SDS) and height velocity of patients with ISS in Korea who received GH treatment. Methods We retrospectively reviewed and performed linear mixed model and survival analyses on data from 12 tertiary hospitals in Korea, including subjects diagnosed with ISS from January 2009 to September 2019, treated with GH therapy for more than 6 months, and who were at a pre-pubertal state at the time of diagnosis. Results We included 578 children (330 boys and 248 girls). The mean daily dose of GH in this study was 0.051 mg/kg, which was lower than the approved dose in Korea of 0.062 - 0.067 mg/kg. Height SDS was higher in patients who started treatment before the age of 6 years. The probability of reaching the target SDS (-1 SDS) from the beginning of treatment to 2-3 years after its start was higher in children starting treatment before the age of 6 years. The hazard ratio to reach the target SDS (-1 SDS) when using automatic pen or electronic devices was 1.727 times higher than that when using the needle and syringe device. Conclusion ISS patients should start GH treatment at an early age, and even lower-than-recommended drug doses may be effective. The selection of automatic pen or electronic device can have a positive effect on reaching the target height SDS.
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Affiliation(s)
- Hyun Wook Chae
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Il-Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Ji-Eun Lee
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Cheol Hwan So
- Department of Pediatrics, Wonkwang University Hospital, Jeollabuk-do, South Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Gyeonggi-do, South Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
| | - Eun Byul Kwon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea
| | - Kyung Hee Yi
- Department of Pediatrics, Wonkwang University Sanbon Medical Center, Gyeonggi-do, South Korea
| | - Eun Young Kim
- Department of Pediatrics, Chosun University Hospital, Gwangju, South Korea
| | - Chae-Ku Jo
- Department of Pediatrics, Dong-A University College of Medicine, Busan, South Korea
| | - Kye Shik Shim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Ha-Yeong Gil
- Medical Research Project Team, Internal Medicine (IM) Medical, Pfizer Korea, Seoul, South Korea
| | - Min-Jeong Seong
- Rare Disease, Medical Affairs, Pfizer Korea, Seoul, South Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Su Moon
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University Hospital, Gyeonggi-do, South Korea
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11
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Park M, Kim YJ, Oh KE, Kang E, Nam HK, Rhie YJ, Lee KH. The association between idiopathic scoliosis and growth hormone treatment in short children. Ann Pediatr Endocrinol Metab 2022; 27:207-213. [PMID: 35592900 PMCID: PMC9537675 DOI: 10.6065/apem.2142186.093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Idiopathic scoliosis is the most common form of scoliosis, and the risk of onset and progression has been found to correlate with growth spurts. Therefore, treatment with recombinant human growth hormone (GH) treatment in short children may initiate and/or aggravate scoliosis. The aim of this study was to investigate the relationship between idiopathic scoliosis and GH treatment in short children. METHODS The medical records of 113 subjects seen at the participating institution between January 2010 and December 2020 and who were diagnosed with GH deficiency and small for gestational age, had idiopathic short stature, and were treated with GH for at least one year were reviewed. Scoliosis was defined as a Cobb angle greater than 10 degrees as assessed using a spine x-ray. Clinical data and laboratory findings before and 12 months after GH treatment were compared. RESULTS There was significant increase in height, height-standard deviation score, insulin-like growth factor 1, and insulin-like growth factor binding protein 3 (p<0.001) with GH treatment. However, there were no significant differences in the average Cobb angle (6.2°±3.3° vs. 6.1°±3.5°, p=0.842) and the prevalence of scoliosis (9.7% vs. 13.3%, p=0.481) before and after one year of GH treatment. A comparative analysis of both initial Cobb angle and change in Cobb angle during GH treatment showed no relationship with other factors. CONCLUSION Although GH treatment in short children increased height and growth velocity, it was not associated with development or aggravation of idiopathic scoliosis.
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Affiliation(s)
- Mijin Park
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Yu Jin Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Eun Oh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea,Address for correspondence: Young-Jun Rhie Department of Pediatrics, Korea University College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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Clinical Practice Pattern of Korean Medicine Doctors in Idiopathic Short Stature Treatment: A Survey Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1505643. [PMID: 35990833 PMCID: PMC9385298 DOI: 10.1155/2022/1505643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
Abstract
Background Korean medicine (KM) interventions are attractive for children with idiopathic short stature (ISS). We investigated the real-world clinical practice patterns of KM doctors in ISS treatment. Methods The survey targeted KM doctors who have treated patients with ISS in KM clinical settings for >3 years. We included questions on the diagnosis and treatment patterns, effects, cost, and opinions of doctors on KM treatment for ISS. A frequency analysis was performed. Results There were 58 respondents, and “heights of parents” (n = 57, 98.3%), “height, weight, and growth rate of child” (n = 55, 94.8%), and “amount of meals, digestive function” (n = 52, 89.7%) were frequently used as indicators for diagnosis and treatment. The most frequently used KM interventions were “herbal medicine” (n = 58, 100%), “acupuncture” (n = 49, 84.5%), “moxibustion” (n = 38, 65.5%), “dry cupping” (n = 26, 44.8%), and “physiotherapy” (n = 22, 37.9%). Herbal medicines were generally prescribed to tonify the spleen or kidney, and the most frequently used individual herbs were Acanthopanacis cortex, Astragali Radix, and Cervi parvum cornu. The most common acupuncture points were ST36, GB34, SP6, EX-LE5, and LI4. Conclusions This study showed the use of KM for ISS in real-world clinical settings. In the future, well-designed clinical studies to verify the effect of KM treatment on ISS based on real-world clinical practice patterns should be actively performed.
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Effectiveness and Safety of Combination Therapy with Herbal Medicine and Growth Hormone Compared to Growth Hormone Monotherapy for Short Stature Children: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5725258. [PMID: 35982997 PMCID: PMC9381207 DOI: 10.1155/2022/5725258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 07/19/2022] [Indexed: 11/18/2022]
Abstract
Introduction Herbal medicines (HM) and growth hormones (GH) are widely used to treat short stature (SS) in children. This systematic review aimed to evaluate the effectiveness and safety of combination therapy with HM and GH (CHG) compared to those of GH monotherapy (GHM) in children with SS. Methods We searched 17 electronic databases from inception to 1 April 2021. Only randomized controlled trials (RCTs) were included. Two authors independently performed the selection and quality assessment of the included studies using Cochrane Handbook criteria. Relative risk (RR) was used to measure dichotomous outcomes with a 95% confidence interval (CI). Mean difference (MD) or standard MD (SMD) was used to measure continuous outcomes with a 95% CI. Results Seven RCTs involving 455 participants with SS were included. Standard deviations in height (MD = 0.31, 95% CI: 0.24–0.38, p < 0.00001), and insulin-like growth factor binding protein-3 (MD = 1.39, 95% CI: 0.93–1.85, p < 0.00001) were significantly higher in the CHG group than in the GHM group. Growth velocity (MD = 1.82, 95% CI: 1.34–2.31, p < 0.00001) and insulin-like growth factor-1 (MD = 61.85, 95% CI: 55.80–67.90, p < 0.00001) were significantly higher in the CHG group. Adverse events were significantly lower in the CHG group (risk ratio: 0.10, 95% CI: 0.02–0.54, p = 0.007). However, the level of evidence was low. Conclusions CHG demonstrated significantly better efficacy than GHM for treating SS, with a low incidence of adverse events. However, since the level of evidence is low, methodologically standardized RCTs are required to verify these results.
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Chinese herbal medicine for children with idiopathic short stature (ISS): A systematic review and meta-analysis. PLoS One 2022; 17:e0270511. [PMID: 35749540 PMCID: PMC9232169 DOI: 10.1371/journal.pone.0270511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Idiopathic short stature (ISS) describes a heterogeneous group of children of many unidentified causes of short stature presently without definitive therapy. Chinese herbal medicine (CHM) is an alternative and complementary treatment for children with ISS and has been widely used for ISS while the evidence of its effectiveness is controversial. We conducted this systematic review and meta-analysis in order to evaluate the efficacy of CHM for ISS. Methods PubMed, Embase, Web of science, Sino-Med, Cochrane, CNKI, VIP, and Wangfang Data were electronically searched to collect randomized controlled trials (RCTs) of CHM treatment of ISS from inception to May 2021. Two researchers independently scanned the literature and extracted information on general characteristics, including patient, study design, interventions, and side effects, assessing the CHM intervention’s efficacy and the risk of bias. Height, bone age, growth velocity, and IGF-1 level are the main consequences. Height standard deviations score (HtSDS), change in HtSDS (ΔHtSDS), osteocalcin, the peak level of growth hormones (GHP), and predicted adult height (PAH) are the secondary outcomes. Meta-analysis was then performed by using RevMan 5.3 (Cochrane Collaboration). Results Seven articles (569 participants) were included. The Meta-analysis indicated that herbal medicine was associated with increased height (MD 2.16 points; 95%CI, 0.22 to 4.10; P = 0.03), growth velocity (MD 1.47 points; 95%CI, 0.28 to 2.67; P = 0.02), IGF-1 level (MD 28.13 points; 95%CI, 22.80 to 33.46; P<0.00001) and GHP (MD 3.29 points; 95%CI, 1.54 to 5.04; P = 0.0002). Conclusion According to current research, CHM appears to be useful for children with ISS. Due to the limited quality and number of studies included, more high-quality studies are needed to corroborate the above conclusions.
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Ahn J, Oh J, Suh J, Song K, Kwon A, Chae HW, Oh JS, Lee HI, Lee MS, Kim HS. Next-generation sequencing-based mutational analysis of idiopathic short stature and isolated growth hormone deficiency in Korean pediatric patients. Mol Cell Endocrinol 2022; 544:111489. [PMID: 34653508 DOI: 10.1016/j.mce.2021.111489] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
We investigated the distribution of short stature-associated mutations in Korean pediatric patients with idiopathic short stature (ISS) and isolated growth hormone deficiency (IGHD) via targeted next-generation sequencing (TNGS). We employed a 96-gene TNGS panel for short stature in a total of 144 patients (5-19 years-old) previously diagnosed with ISS or IGHD and identified heterozygous pathogenic or likely pathogenic genetic variants in 14 (10%) patients. Of the mutated genes, PROKR2 (n = 3) is associated with gonadotropin-releasing hormone deficiency or hypopituitarism, while FGFR1 (n = 1) and NPR2 (n = 3) encode growth plate paracrine factors. FBN1 (n = 1), COL9A1 (n = 1), MATN3 (n = 1), and ACAN (n = 3) regulate the cartilage extracellular matrix, while PTPN11 (n = 1) controls intracellular pathways. Six patients had IGHD, and eight patients had ISS. The current findings highlight the utility of TNGS for determining the genetic etiology in these patients.
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Affiliation(s)
- Jungmin Ahn
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea; Department of Pediatrics, Jeju National University, College of Medicine and Graduate, School of Medicine, Jeju, South Korea
| | - Jiyoung Oh
- Division of Clinical Genetics, Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Kyungchul Song
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Jun Suk Oh
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Hae In Lee
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Myeong Seob Lee
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, College of Medicine Yonsei University, Seoul, South Korea.
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Tidblad A, Gustafsson J, Marcus C, Ritzén M, Ekström K. Metabolic Effects of Growth Hormone Treatment in Short Prepubertal Children: A Double-Blinded Randomized Clinical Trial. Horm Res Paediatr 2022; 93:519-528. [PMID: 33684919 DOI: 10.1159/000513518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Growth hormone (GH) is a central hormone for regulating linear growth during childhood and also highly involved in the metabolism of lipids, carbohydrates, and protein. However, few studies report on how treatment with GH during childhood influences metabolic parameters. Our aim was to investigate metabolic effects of different doses of GH in short children with GH peak levels in the low to normal range. DESIGN Thirty-five prepubertal short children (<-2.5 SDS), aged 7-10 years, with peak levels of GH between 7 and 14 μg/L during an arginine-insulin tolerance test, were randomized to 3 different doses (11/33/100 μg/kg/day) of GH treatment for 2 years. Auxological and metabolic investigations were performed. These included metabolites in blood and interstitial microdialysis fluid, dual-energy X-ray absorptiometry, frequently sampled intravenous glucose tolerance test (FSIVGTT), and stable isotope examinations of rates of glucose production and lipolysis. RESULTS At 24 months, the high-dose group (HD) had higher fasting insulin compared with the standard-dose (SD) and low-dose (LD) groups (HD: 111.7 vs. SD: 61.2 and LD: 46.0 pmol/L [p < 0.001]) and showed signs of insulin resistance (HOMA-IR, HD: 4.20 vs. SD: 2.17 and LD: 1.71 (LD) [p < 0.001]). The FSIVGTT also demonstrated higher acute insulin response (p < 0.05). Few other metabolic differences were found at 24 months, but a decreased insulin sensitivity index (Si) could already be seen at 12 months for both SD and HD compared with the LD group (p < 0.05). CONCLUSION Treatment with GH resulted in a dose-dependent decrease in insulin sensitivity, demonstrated by higher levels of fasting insulin and signs of insulin resistance in both HOMA indices and FSIVGTT examinations.
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Affiliation(s)
- Anders Tidblad
- Department of Women's and Children's Health, Division of Pediatric Endocrinology, Karolinska Institutet, Stockholm, Sweden,
| | - Jan Gustafsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Claude Marcus
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Martin Ritzén
- Department of Women's and Children's Health, Division of Pediatric Endocrinology, Karolinska Institutet, Stockholm, Sweden
| | - Klas Ekström
- Department of Women's and Children's Health, Division of Pediatric Endocrinology, Karolinska Institutet, Stockholm, Sweden
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Willems M, Amouroux C, Barat-Houari M, Salles JP, Edouard T. Exploring the genetic causes of isolated short stature. What has happened to idiopathic short stature? Arch Pediatr 2022; 28:8S27-8S32. [PMID: 37870530 DOI: 10.1016/s0929-693x(22)00040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Statural growth is underpinned by development of the growth plate during the process of endochondral ossification, which is strongly regulated by numerous local factors (intracellular, paracrine and extracellular matrix factors) and systemic factors (nutrition, hormones, proinflammatory cytokines and extracellular fluids). This explains why growth retardation can be associated with numerous pathologies, particularly genetic syndromes, hormonal or inflammatory conditions, or gastrointestinal disorders having a nutritional impact. However, in most cases (80%), no specific aetiology is found after clinical investigation and conventional additional tests have been carried out. In such cases, "idiopathic" short stature is diagnosed, which includes patients presenting with constitutional delay of growth and development and familial short stature, but also patients with very subtle constitutional skeletal dysplasia which are not easily identifiable. In recent years, new methods of genetic investigation (e.g. gene panels, exome or genome sequencing) have made it possible to identify many genetic variants associated with apparently isolated short stature. Indeed, it is still difficult to estimate the proportion of patients presenting with idiopathic short stature for which a molecular diagnosis of monogenic conditions could be made. This estimate varies hugely depending on the thoroughness of the clinical, laboratory and radiological assessments performed prior to molecular analysis, since retrospective analysis of positive cases usually reveals subtle signs of underlying syndromes or rare skeletal disorders. Molecular diagnosis in children is important to be able to offer genetic counselling and to organise patient management. Moreover, improved understanding of the molecular basis of these cases of short stature opens up numerous possibilities for more specific treatments targeting the growth plate. © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- M Willems
- Medical Genetic Department for Rare Diseases and Personalised Medicine, Reference Centre AD SOOR, AnDDI-RARE, Competence Centre for Rare Skeletal Disorders, OSCAR Network, Inserm U1298, INM, Arnaud de Villeneuve Hospital and University of Montpellier, Montpellier, France
| | - C Amouroux
- Paediatric Endocrine Unit, Competence Centre for Rare Diseases of Calcium and Phosphate Metabolism, OSCAR Network, Arnaud de Villeneuve Hospital and University of Montpellier, Montpellier, France
| | - M Barat-Houari
- Molecular Biology Unit, Competence Centre for Rare Skeletal Disorders, OSCAR Network, Arnaud de Villeneuve Hospital and University of Montpellier, Montpellier, France
| | - J-P Salles
- Endocrine, Bone Diseases and Genetics Unit, Reference Centre for Rare Diseases of Calcium and Phosphate Metabolism and Competence Centre for Rare Skeletal Disorders, ERN BOND, OSCAR Network, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - T Edouard
- Endocrine, Bone Diseases and Genetics Unit, Reference Centre for Rare Diseases of Calcium and Phosphate Metabolism and Competence Centre for Rare Skeletal Disorders, ERN BOND, OSCAR Network, Children's Hospital, Toulouse University Hospital, Toulouse, France.
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Shirasaka T, Kunioka S, Kikuchi Y, Isikawa N, Kanda H, Kamiya H. Does a Small Body Have a Negative Impact on Minimally Invasive Mitral Valve Surgery? Front Surg 2022; 8:746302. [PMID: 35174202 PMCID: PMC8841515 DOI: 10.3389/fsurg.2021.746302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundsMinimally invasive mitral valve surgery (MIMVS) in patients with a small body presents surgeons with a technically difficult surgical maneuver. We hypothesized that physique might negatively influence the safety and technical complexity of MIMVS.MethodsOne hundred and twenty-one patients underwent MIMVS in our institution between May 2014 and April 2020. These patients were categorized into two groups. The first group was the small physique group (n = 20) consisting of patients with a stature <150 cm. The second group was the normal physique group (n = 101) consisting of patients with a stature >150 cm. The primary endpoint was freedom from death and major adverse cardiovascular and cerebrovascular events (MACCE). The secondary endpoint was freedom from moderate or severe mitral regurgitation.ResultsCardiopulmonary bypass time (130 ± 29 vs. 156 ± 55 min, p = 0.02) and aortic cross-clamp time (75 ± 27 vs. 95 ± 39 min, p = 0.03) were significantly shorter in the small physique group. Both in the early and midterm periods, there was no significant difference in the mortality (early, 5.0 vs. 1.0%, p = 0.30. midterm, 5.0 vs. 1.0%, p = 0.09), MACCE (early, 5.0 vs. 6.9%, p = 0.65. midterm, 5.0 vs. 5.9%, p = 0.93) and the residual MR (early, 0 vs. 1.0%, p = 0.66. midterm, 5.0 vs. 4.9%, p = 0.93) between the two groups.ConclusionsSmall physique is not a hurdle for MIMVS in terms of the safety of the operation.
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Affiliation(s)
- Tomonori Shirasaka
- Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Shingo Kunioka
- Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan
- *Correspondence: Shingo Kunioka
| | - Yuta Kikuchi
- Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Natsuya Isikawa
- Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Hirotsugu Kanda
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroyuki Kamiya
- Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan
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Lee B, Kwon CY, Jang S. Comparative effectiveness of East Asian traditional medicine for treatment of idiopathic short stature in children: systematic review and network meta-analysis. Integr Med Res 2022; 11:100832. [PMID: 35145854 PMCID: PMC8801998 DOI: 10.1016/j.imr.2022.100832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/01/2021] [Accepted: 01/03/2022] [Indexed: 01/23/2023] Open
Abstract
Background Idiopathic short stature (ISS) is a common problem in children and causes many economic and social burdens. In Asian countries, East Asian traditional medicine (EATM) therapies are widely used for children with ISS. In this study, we compared and ranked various EATM therapies for the treatment of pediatric ISS using network meta-analysis. Methods Randomized controlled trials that evaluated various EATMs for pediatric ISS were found through searching 14 electronic databases. The primary outcome was growth velocity (GV). The comparative effectiveness of the treatments was ranked based on the surface under the cumulative ranking curve (SUCRA) and the risk of bias was assessed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Results Fourteen studies comprising 1,066 participants were included. HM plus GH showed statistically significant superiority over other EATM therapies including acupuncture (weighted mean difference (WMD) 3.20 cm, 95% confidence interval (CI) 0.40 to 5.99) and HM (WMD 3.70 cm, 95% CI 1.41 to 5.99) for improving GV per year, although there was no difference compared with GH alone (WMD 1.18 cm, 95% CI -0.27 to 2.63). SUCRA indicated that HM plus GH was the most effective therapy for increasing GV, followed by GH, HM plus acupressure, and HM. No serious adverse events were reported. Conclusion For the treatment of ISS, HM plus GH might have a large beneficial effect and might be a better option than EATM therapies and GH alone. However, more long-term, high-quality trials are warranted to confirm the findings. Protocol registration PROSPERO (https://www.crd.york.ac.uk/prospero/), CRD42020187160.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Corresponding author at: KM Science Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, South Korea.
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea
| | - Soobin Jang
- Department of Preventive Medicine, College of Korean Medicine, Daegu Haany University, Gyeongsan, South Korea
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Savage MO, Storr HL. GH Resistance Is a Component of Idiopathic Short Stature: Implications for rhGH Therapy. Front Endocrinol (Lausanne) 2021; 12:781044. [PMID: 34956092 PMCID: PMC8702638 DOI: 10.3389/fendo.2021.781044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
Idiopathic short stature (ISS) is a term used to describe a selection of short children for whom no precise aetiology has been identified. Molecular investigations have made notable discoveries in children with ISS, thus removing them from this category. However, many, if not the majority of children referred with short stature, are designated ISS. Our interest in defects of GH action, i.e. GH resistance, has led to a study of children with mild GH resistance, who we believe can be mis-categorised as ISS leading to potential inappropriate management. Approval of ISS by the FDA for hGH therapy has resulted in many short children receiving this treatment. The results are extremely variable. It is therefore important to correctly assess and investigate all ISS subjects in order to identify those with mild but unequivocal GH resistance, as in cases of PAPP-A2 deficiency. The correct identification of GH resistance defects will direct therapy towards rhIGF-I rather than rhGH. This example illustrates the importance of recognition of GH resistance among the very large number patients referred with short stature who are labelled as 'ISS'.
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Affiliation(s)
- Martin O. Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
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21
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Di Biase AR, Marasco G, Ravaioli F, Colecchia L, Dajti E, Lecis M, Passini E, Alemanni LV, Festi D, Iughetti L, Colecchia A. Clinical Presentation of Celiac Disease and Diagnosis Accuracy in a Single-Center European Pediatric Cohort over 10 Years. Nutrients 2021; 13:4131. [PMID: 34836386 PMCID: PMC8625284 DOI: 10.3390/nu13114131] [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] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
(1) Background: Changes in the clinical presentation of celiac disease (CD) in children have been reported. The guidelines of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) allow esophagogastroduodenoscopy (EGD) with biopsies to be avoided under specific circumstances. We aimed to assess the clinical picture of pediatric CD patients at diagnosis and to validate ESPGHAN non-biopsy criteria. (2) Methods: Patients with suspected CD or undergoing screening from 2004 to 2014 at the University Hospital in Modena, Italy were enrolled. The accuracy of ESPGHAN non-biopsy criteria and modified versions were assessed. (3) Results: In total, 410 patients were enrolled, of whom 403 were considered for analysis. Of the patients considered, 45 were asymptomatic and diagnosed with CD (11.2%) while 358 patients (88.2%) were symptomatic, of whom 295 were diagnosed with CD. Among symptomatic CD patients, 57 (19.3%) had gastrointestinal symptoms, 98 (33%) had atypical symptoms and 140 (47.4%) had both. No difference was found for the presence of gastrointestinal symptoms at different ages. The non-biopsy ESPGHAN criteria yielded an accuracy of 59.4% with a positive predictive value (PPV) of 100%; 173 out of 308 EGD (56.2%) could have been avoided. The modified 7× and 5× upper limit of normal cut-offs for IgA anti tissue-transglutaminase reached 60.7% and 64.3% of EGD avoided, respectively. (4) Conclusions: Over 10 years, late age at diagnosis and increased rates of atypical CD presentation were found. ESPGHAN non-biopsy criteria are accurate for CD diagnosis and allow half of unneeded EGD to be avoided. Modified versions allowed sparing a greater number of EGD.
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Affiliation(s)
- Anna Rita Di Biase
- Pediatric Unit, Modena University Hospital, 41124 Modena, Italy; (A.R.D.B.); (M.L.); (E.P.); (L.I.)
| | - Giovanni Marasco
- Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.R.); (E.D.); (L.V.A.)
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Federico Ravaioli
- Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.R.); (E.D.); (L.V.A.)
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Luigi Colecchia
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Elton Dajti
- Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.R.); (E.D.); (L.V.A.)
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Marco Lecis
- Pediatric Unit, Modena University Hospital, 41124 Modena, Italy; (A.R.D.B.); (M.L.); (E.P.); (L.I.)
| | - Erica Passini
- Pediatric Unit, Modena University Hospital, 41124 Modena, Italy; (A.R.D.B.); (M.L.); (E.P.); (L.I.)
| | - Luigina Vanessa Alemanni
- Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy; (F.R.); (E.D.); (L.V.A.)
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Davide Festi
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.C.); (D.F.)
| | - Lorenzo Iughetti
- Pediatric Unit, Modena University Hospital, 41124 Modena, Italy; (A.R.D.B.); (M.L.); (E.P.); (L.I.)
| | - Antonio Colecchia
- Gastroenterology Unit, Modena University Hospital, 41124 Modena, Italy;
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Detection of Del/Dup Inside SHOX/PAR1 Region in Children and Young Adults with Idiopathic Short Stature. Genes (Basel) 2021; 12:genes12101546. [PMID: 34680940 PMCID: PMC8535414 DOI: 10.3390/genes12101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 12/05/2022] Open
Abstract
Short stature is a common growth disorder defined as a body height two standard deviations (SD) or more below the mean for a given age, gender, and population. A large part of the cases remains unexplained and is referred to as having idiopathic short stature (ISS). One of the leading genetic causes of short stature is variants of short stature homeobox-containing gene (SHOX) and is considered to be responsible for 2–15% of ISS. We aimed to analyse the regulatory and coding region of SHOX in Slovenian children and young adults with ISS and to investigate the pathogenicity of detected variants. Our cohort included 75 children and young adults with ISS. Multiplex ligation-dependent probe amplification (MLPA) was performed in all participants for the detection of larger copy number variations (CNVs). Sanger sequencing was undertaken for the detection of point variants, small deletions, and insertions. A total of one deletion and two duplications were discovered using the MLPA technique. Only one of these four variants was identified as disease-causing and occurred in one individual, which represents 1.3% of the cohort. With Sanger sequencing, two variants were discovered, but none of them appeared to have a pathogenic effect on height. According to the results, in the Slovenian population of children and young adults with ISS, SHOX deficiency is less frequent than expected considering existing data from other populations.
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Alsafadi D, Ezzat A, Altamimi F, ElBagoury M, Olfat M, Saleh M, Roushdy S, Aktham Y. Mucopolysaccharidosis Type I Disease Prevalence Among Patients With Idiopathic Short Stature in Saudi Arabia: Protocol for a Multicenter Cross-sectional Study. JMIR Res Protoc 2021; 10:e28619. [PMID: 34463634 PMCID: PMC8441598 DOI: 10.2196/28619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Since the underlying cause of idiopathic short stature can indeed be undiagnosed mucopolysaccharidosis type I, it is critical to identify patients with mucopolysaccharidosis type I among screened patients with idiopathic short stature. Objective The primary objective of this study is to determine the prevalence of mucopolysaccharidosis type I disease in a high-risk group (ie, patients with idiopathic short stature). Methods We plan to perform a multicenter, cross-sectional screening study to primarily assess the prevalence of mucopolysaccharidosis type I disease in patients with idiopathic short stature. All eligible patients will be tested after obtaining written informed consent from their parents and guardians. Eligible patients will be recruited over 18 months from specialty care centers for pediatrics and genetics. Results This protocol was approved by the Institutional Review Board of King Fahd Medical City and funded by Sanofi Genzyme Saudi Arabia. We expect to collect data from ≥800 patients, as determined by our sample size calculation. Conclusions Saudi Arabia is the largest country in the Arabian Peninsula; it has a population of more than 28 million people. To date, there are no reliable data regarding the incidence and prevalence of mucopolysaccharidosis type I in Saudi Arabia; therefore, future multicenter studies will be needed. Further, the prevalence of an attenuated form of mucopolysaccharidosis type I is largely underestimated in Saudi Arabia due to the absence of an effective newborn screening program. Therefore, the implementation of a nationwide newborn screening program is essential for the accurate estimation of the burden of mucopolysaccharidosis and the early diagnosis of patients. International Registered Report Identifier (IRRID) PRR1-10.2196/28619
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Affiliation(s)
- Danyah Alsafadi
- Al Aziziah Maternity and Children Hospital, Jeddah, Saudi Arabia
| | - Aly Ezzat
- Medical Affairs Department, Sanofi-Genzyme, Jeddah, Saudi Arabia
| | | | - Marwan ElBagoury
- Medical Affairs Department, Sanofi-Genzyme, Jeddah, Saudi Arabia
| | | | | | - Sherif Roushdy
- Medical Affairs Department, Sanofi-Genzyme, Jeddah, Saudi Arabia
| | - Yahia Aktham
- Medical Affairs Department, Sanofi-Genzyme, Jeddah, Saudi Arabia
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Estrada K, Froelich S, Wuster A, Bauer CR, Sterling T, Clark WT, Ru Y, Trinidad M, Nguyen HP, Luu AR, Wendt DJ, Yogalingam G, Yu GK, LeBowitz JH, Cardon LR. Identifying therapeutic drug targets using bidirectional effect genes. Nat Commun 2021; 12:2224. [PMID: 33850126 PMCID: PMC8044152 DOI: 10.1038/s41467-021-21843-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 02/12/2021] [Indexed: 01/15/2023] Open
Abstract
Prioritizing genes for translation to therapeutics for common diseases has been challenging. Here, we propose an approach to identify drug targets with high probability of success by focusing on genes with both gain of function (GoF) and loss of function (LoF) mutations associated with opposing effects on phenotype (Bidirectional Effect Selected Targets, BEST). We find 98 BEST genes for a variety of indications. Drugs targeting those genes are 3.8-fold more likely to be approved than non-BEST genes. We focus on five genes (IGF1R, NPPC, NPR2, FGFR3, and SHOX) with evidence for bidirectional effects on stature. Rare protein-altering variants in those genes result in significantly increased risk for idiopathic short stature (ISS) (OR = 2.75, p = 3.99 × 10-8). Finally, using functional experiments, we demonstrate that adding an exogenous CNP analog (encoded by NPPC) rescues the phenotype, thus validating its potential as a therapeutic treatment for ISS. Our results show the value of looking for bidirectional effects to identify and validate drug targets.
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Affiliation(s)
| | | | | | | | | | | | - Yuanbin Ru
- BioMarin Pharmaceutical Inc., Novato, CA, USA
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Cong M, Qiu S, Li R, Sun H, Cong L, Hou Z. Development of a predictive model of growth hormone deficiency and idiopathic short stature in children. Exp Ther Med 2021; 21:494. [PMID: 33791003 PMCID: PMC8005695 DOI: 10.3892/etm.2021.9925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to develop predictive models using clinical features and MRI texture features for distinguishing between growth hormone deficiency (GHD) and idiopathic short stature (ISS) in children with short stature. This retrospective study included 362 children with short stature from Children's Hospital of Hebei Province. GHD and ISS were identified via the GH stimulation test using arginine. Overall, there were 190 children with GHD and 172 with ISS. A total of 57 MRI texture features were extracted from the pituitary gland region of interest using C++ language and Matlab software. In addition, the laboratory examination data were collected. Receiver operating characteristic (ROC) regression curves were generated for the predictive performance of clinical features and MRI texture features. Logistic regression models based on clinical and texture features were established for discriminating children with GHD and ISS. Two clinical features [IGF-1 (insulin growth factor-1) and IGFBP-3 (IGF binding protein-3) levels] were used to build the clinical predictive model, whereas the three best MRI textures were used to establish the MRI texture predictive model. The ROC analysis of the two models revealed predictive performance for distinguishing GHD from ISS. The accuracy of predicting ISS from GHD was 64.5% in ROC analysis [area under the curve (AUC), 0.607; sensitivity, 57.6%; specificity, 72.1%] of the clinical model. The accuracy of predicting ISS from GHD was 80.4% in ROC analysis (AUC, 0.852; sensitivity, 93.6%; specificity, 65.8%) of the MRI texture predictive model. In conclusion, these findings indicated that a texture predictive model using MRI texture features was superior for distinguishing children with GHD from those with ISS compared with the model developed using clinical features.
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Affiliation(s)
- Mengdi Cong
- Department of Computed Tomography and Magnetic Resonance, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, P.R. China
| | - Shi Qiu
- Key Laboratory of Spectral Imaging Technology Chinese Academy of Science, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an, Shaanxi 710119, P.R. China
| | - Rongpin Li
- Department of Computed Tomography and Magnetic Resonance, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, P.R. China
| | - Haiyan Sun
- Department of Computed Tomography and Magnetic Resonance, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, P.R. China
| | - Lining Cong
- Department of Radiology, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, P.R. China
| | - Zhenzhou Hou
- Department of Computed Tomography and Magnetic Resonance, Children's Hospital of Hebei Province, Shijiazhuang, Hebei 050031, P.R. China
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Rapaport R, Wit JM, Savage MO. Growth failure: 'idiopathic' only after a detailed diagnostic evaluation. Endocr Connect 2021; 10:R125-R138. [PMID: 33543731 PMCID: PMC8052574 DOI: 10.1530/ec-20-0585] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/29/2021] [Indexed: 01/02/2023]
Abstract
The terms 'idiopathic short stature' (ISS) and 'small for gestational age' (SGA) were first used in the 1970s and 1980s. ISS described non-syndromic short children with undefined aetiology who did not have growth hormone (GH) deficiency, chromosomal defects, chronic illness, dysmorphic features or low birth weight. Despite originating in the pre-molecular era, ISS is still used as a diagnostic label today. The term 'SGA' was adopted by paediatric endocrinologists to describe children born with low birth weight and/or length, some of whom may experience lack of catch-up growth and present with short stature. GH treatment was approved by the FDA for short children born SGA in 2001, and by the EMA in 2003, and for the treatment of ISS in the US, but not Europe, in 2003. These approvals strengthened the terms 'SGA' and 'ISS' as clinical entities. While clinical and hormonal diagnostic techniques remain important, it is the emergence of genetic investigations that have led to numerous molecular discoveries in both ISS and SGA subjects. The primary message of this article is that the labels ISS and SGA are not definitive diagnoses. We propose that the three disciplines of clinical evaluation, hormonal investigation and genetic sequencing should have equal status in the hierarchy of short stature assessments and should complement each other to identify the true pathogenesis in poorly growing patients.
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Affiliation(s)
- Robert Rapaport
- Division of Pediatric Endocrinology & Diabetes, Mount Sinai Kravis Children’s Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK
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Savage MO, Storr HL, Backeljauw PF. The continuum between GH deficiency and GH insensitivity in children. Rev Endocr Metab Disord 2021; 22:91-99. [PMID: 33025383 DOI: 10.1007/s11154-020-09590-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 01/25/2023]
Abstract
The continuum of growth hormone (GH)-IGF-I axis defects extends from severe to mild GH deficiency, through short stature disorders of undefined aetiology, to GH insensitivity disorders which can also be mild or severe. This group of defects comprises a spectrum of endocrine, biochemical, phenotypic and genetic abnormalities. The extreme cases are generally easily diagnosed because they conform to well-studied phenotypes with recognised biochemical features. The milder cases of both GH deficiency and GH insensitivity are less well defined and also overlap with the group of short stature conditions, labelled as idiopathic short stature (ISS). In this review the continuum model, which plots GH sensitivity against GH secretion, will be discussed. Defects causing GH deficiency and GH insensitivity will be described, together with the use of a diagnostic algorithm, designed to aid investigation and categorisation of these defects. The continuum will also be discussed in the context of growth-promoting endocrine therapy.
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Affiliation(s)
- Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK.
- John Vane Science Centre, William Harvey Research Institute, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Helen L Storr
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK
| | - Philippe F Backeljauw
- Division of Endocrinology, Cincinnati Center for Growth Disorders, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
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Lee B, Kwon CY. Review of economic analysis of available interventions on idiopathic short stature: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24871. [PMID: 33607861 PMCID: PMC7899841 DOI: 10.1097/md.0000000000024871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Idiopathic short stature (ISS) causes a high economic burden worldwide. As part of a research project that synthesizes economic evidence for Korean medicine treatment of ISS, we describe the methods that will be used for the comprehensive review of articles that analyze health-related economic evaluation for available interventions for ISS using a systematic review methodology. METHODS Eight electronic English, Korean, and Chinese databases will be searched from their inception until December 2020 to identify studies on the economic evaluation of available interventions on ISS, without language, study design, or publication status restrictions. From the included studies, the effectiveness, utility, and cost data will be collected as the outcome measures by two researchers independently. Descriptive analysis of individual studies will be conducted. If it is judged that the interventions and outcomes of the included studies are sufficiently homogeneous, we will attempt a quantitative synthesis through meta-analysis using Review Manager version 5.4 software (Cochrane, London, UK). RESULTS This study will summarize the evidence regarding the economic evaluation of available interventions for ISS. CONCLUSIONS The findings of this review will help clinicians and patients in evidence-based decision-making in clinical settings and help policy makers develop effective policies and distribute resources based on the available evidence.
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Affiliation(s)
- Boram Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, 62 Yangjeong-ro, Busanjin-gu, Busan, Republic of Korea
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29
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Singh AD, Singh P, Farooqui N, Strand T, Ahuja V, Makharia GK. Prevalence of celiac disease in patients with short stature: A systematic review and meta-analysis. J Gastroenterol Hepatol 2021; 36:44-54. [PMID: 32621396 DOI: 10.1111/jgh.15167] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Short stature is a common extraintestinal manifestation of celiac disease (CeD). We conducted a systematic review and meta-analysis to assess the global prevalence of CeD in patients presenting with short stature. METHODS We searched Medline and EMBASE databases for the keywords "celiac disease, coeliac disease, anti-gliadin, tissue transglutaminase antibody, anti-endomysial antibody, short stature and growth retardation." All the studies published from January 1991 to May 2020 were included. Patients without any prior evaluation for short stature were classified as all-cause short stature, while prior evaluated patients, where no cause was found for short stature, were classified as idiopathic short stature. The diagnosis of CeD was based on the European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines. A random-effects model was used to pool the data. RESULTS Seventeen studies screening 3759 patients (1582 with all-cause short stature and 2177 with idiopathic short stature) were included. The pooled seroprevalence of CeD based on positive anti-tissue transglutaminase antibody and anti-endomysial antibody was 11.2% (95% CI 4.0-21.2%; I2 = 86%) and 9.7% (95% CI 2.7-20.2%; I2 = 95%) for all-cause and idiopathic short stature, respectively. Similarly, pooled prevalence of biopsy-confirmed CeD was 7.4% (95% CI 4.7-10.6%; I2 = 76%) and 11.6% (95% CI 4.1-22.2%; I2 = 97%), for all-cause and idiopathic short stature, respectively. There was an overall severe risk of selection bias and significant heterogeneity in the pooled results. CONCLUSIONS Approximately one in 14 patients with all-cause short stature and one in nine patients with idiopathic short stature had biopsy-confirmed CeD. Therefore, evaluation for CeD may be prudent in all patients with short stature.
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Affiliation(s)
- Achintya D Singh
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Prashant Singh
- Department of Gastroenterology, University of Michigan, Ann Arbor, MI, USA
| | - Naba Farooqui
- Department of Gastroenterology and Human nutrition, All India Institute of Medical Sciences, Delhi, New Delhi, India
| | - Tor Strand
- Department of Global public health, Innlandet Hospital Trust, Lillehammer, Norway
| | - Vineet Ahuja
- Department of Gastroenterology and Human nutrition, All India Institute of Medical Sciences, Delhi, New Delhi, India
| | - Govind K Makharia
- Department of Gastroenterology and Human nutrition, All India Institute of Medical Sciences, Delhi, New Delhi, India
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Paltoglou G, Dimitropoulos I, Kourlaba G, Charmandari E. The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis. J Pediatr Endocrinol Metab 2020; 33:1577-1588. [PMID: 33035189 DOI: 10.1515/jpem-2020-0287] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/23/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Idiopathic short stature (ISS) is a recognized, albeit a controversial indication for treatment with recombinant human growth hormone (rhGH).The objective of the present study was to conduct a systematic review of the literature and meta-analyses of selected studies about the use of rhGH in children with ISS on linear growth and adult height (AH). METHODS A systematic literature search was conducted to identify relevant studies published till February 28, 2017 in the following databases: Medline (PubMed), Scopus and Cochrane Central Registry of Controlled Trials. After exclusion of duplicate studies, 3,609 studies were initially identified. Of those, 3,497 studies were excluded during the process of assessing the title and/or the abstract. The remaining 112 studies were evaluated further by assessing the full text; 21 of them fulfilled all the criteria in order to be included in the current meta-analysis. RESULTS Children who received rhGH had significantly higher height increment at the end of the first year, an effect that persisted in the second year of treatment and achieved significantly higher AH than the control group. The difference between the two groups was equal to 5.3 cm (95% CI: 3.4-7 cm) for male and 4.7 cm (95% CI: 3.1-6.3 cm) for female patients. CONCLUSION In children with ISS, treatment with rhGH improves short-term linear growth and increases AH compared with control subjects. However, the final decision should be made on an individual basis, following detailed diagnostic evaluation and careful consideration of both risks and benefits of rhGH administration.
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Affiliation(s)
- George Paltoglou
- Department of Paediatric Endocrinology, Evelina Children's Hospital, London, UK.,Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | | | - Georgia Kourlaba
- Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Lee B, Kwon CY, Jang S. Comparative effectiveness of East Asian traditional medicine for treatment of idiopathic short stature in children: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e22856. [PMID: 33120823 PMCID: PMC7581126 DOI: 10.1097/md.0000000000022856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There are many East Asian traditional medicine (EATM) therapies that are widely used and effective for idiopathic short stature (ISS) in children. However, the comparative effectiveness of these therapies remains unclear. We describe the methods that will be used to comparatively evaluate the efficacy and safety of EATM therapies for the treatment of pediatric ISS. METHODS AND ANALYSIS Fourteen electronic English, Korean, Chinese, and Japanese databases will be searched up to August 2020 for relevant randomized controlled trials of various EATMs for the treatment of pediatric ISS, without language or publication status restrictions. The primary outcome will be growth-related anthropometric indicators, and acceptability, measured through drop-outs that occur during treatment for any reason. We will conduct a pairwise meta-analysis for direct comparisons if multiple studies use the same types of intervention, comparison, and outcome measure. A frequentist network meta-analysis will be performed to summarize the available direct and indirect evidence regarding various EATM options for pediatric ISS. The risk of bias for the included studies will be evaluated using the Cochrane Collaboration's risk of bias tool. CONCLUSIONS The findings of this review will provide evidence for the comparative effectiveness and ranks of current EATMs and help to inform clinical practitioners, patients, and policy makers in decision making. ETHICS AND DISSEMINATION Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentations. PROTOCOL REGISTRATION NUMBER OSF (URL: https://osf.io/s4vp7), PROSPERO CRD42020187160.
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Affiliation(s)
- Boram Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busanjin-gu, Busan, Republic of Korea
| | - Soobin Jang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
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Noorian S, Khonsari NM, Savad S, Hakak-Zargar B, Voth T, Kabir K. Whole-Exome Sequencing in Idiopathic Short Stature: Rare Mutations Affecting Growth. J Pediatr Genet 2020; 10:284-291. [PMID: 34849273 DOI: 10.1055/s-0040-1716400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/26/2020] [Indexed: 12/24/2022]
Abstract
Idiopathic short stature (ISS) is a common diagnosis of exclusion in patients with short stature (SS). In this article, we aimed to identify the genetic causes of SS in patients with ISS and investigate treatment options. Fourteen children with diagnosis of ISS were identified, and whole-exome sequencing (WES) was subsequently conducted on blood-derived DNA. Five patients were correctly diagnosed with ISS and four had rare mutations that have not been previously reported. Four patients had mutations known to cause SS and one had a mutation that was known not to affect height. WES can help identify rare mutations implicated in ISS.
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Affiliation(s)
- Shahab Noorian
- Department of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | | | - Benyamin Hakak-Zargar
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Tessa Voth
- Department of Biomedical Physiology and Kinesiology, Faculty of Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Koroush Kabir
- Department of Community Medicine and Epidemiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Li S, Wang X, Zhao Y, Ji W, Mao J, Nie M, Wu X. Combined therapy with GnRH analogue and growth hormone increases adult height in children with short stature and normal pubertal onset. Endocrine 2020; 69:615-624. [PMID: 32533506 DOI: 10.1007/s12020-020-02375-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/29/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate whether gonadotropin releasing hormone analogue (GnRHa) combined with recombinant human growth hormone (rhGH) can improve the adult height (AHt) of children with short stature and normal pubertal onset. METHODS In this retrospective study, GnRHa/rhGH treatment was given to children with normal pubertal onset and short stature. Patients were followed up to measure their AHt. The primary outcomes were the disparity between AHt standard deviation score (AHt SDS) and pre-treatment height standard deviation score (Ht SDS) and the disparity between AHt and target height (THt). RESULTS A total of 94 patients were included. Forty-nine boys were treated with GnRHa/rhGH for 24.84 ± 13.01 months, and 45 girls were treated for 23.89 ± 10.43 months. (2) Before treatment, the Ht SDS of boys and girls was -1.82 ± 1.30 and -1.10 ± 1.61, respectively, and the target height was 168.98 ± 3.51 cm and 157.90 ± 3.25 cm, respectively. (3) After treatment, for boys, the AHt SDS increased by 1.37 ± 1.28 (p = 0.000) and the disparity between AHt and THt was 0.98 ± 6.18 cm (p = 0.273); for girls, the AHtSDS increased by 1.28 ± 1.48 (p = 0.000), and the disparity between AHt and THt was 3.64 ± 4.86 cm (n = 45, p = 0.000). (4) Subgroup analysis showed that, for boys with idiopathic short stature (ISS) and non-ISS, AHt SDS increased by 2.00 ± 1.16 (p = 0.000) and 0.71 ± 1.06 (p = 0.003) respectively, compared with the pre-treatment HtSDS; The disparities between AHt and THt were -0.70 ± 6.54 cm and 2.73 ± 5.37 cm respectively. For girls with ISS and non-ISS, AHtSDS increased by 2.73 ± 1.21 (p = 0.000) and 0.748 ± 1.19 (p = 0.001), respectively; AHt increased by 2.63 ± 6.12 cm (p = 0.165) and 4.02 ± 4.37 cm (p = 0.000) compared with THt, respectively. (5) Multiple linear regression analysis showed that the baseline bone age (BA) (β = -0.200, p = 0.003), basal IGF-1(β = -0.002, p = 0.008) and HtSDS (β = -0.679, p = 0.000) had negative effects on increment of AHtSDS. CONCLUSION For adolescents with normal pubertal onset and short stature, with or without ISS, GnRHa/rhGH therapy can effectively improve AHtSDS. After treatment, ISS adolescents can reach the THts, and Non-ISS adolescents can exceed their THts.
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Affiliation(s)
- Shuying Li
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Xi Wang
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yaling Zhao
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Wen Ji
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jiangfeng Mao
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China.
| | - Min Nie
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Xueyan Wu
- Division of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China.
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Polidori N, Castorani V, Mohn A, Chiarelli F. Deciphering short stature in children. Ann Pediatr Endocrinol Metab 2020; 25:69-79. [PMID: 32615685 PMCID: PMC7336267 DOI: 10.6065/apem.2040064.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/16/2020] [Indexed: 01/15/2023] Open
Abstract
Short stature is a common reason for referral to pediatric endocrinologists. Multiple factors, including genetic, prenatal, postnatal, and local environmental factors, can impair growth. The majority of children with short stature, which can be defined as a height less than 2 standard deviation score below the mean, are healthy. However, in some cases, they may have an underlying relevant disease; thus, the aim of clinical evaluation is to identify the subset of children with pathologic conditions, for example growth hormone deficiency or other hormonal abnormalities, Turner syndrome, inflammatory bowel disease, or celiac disease. Prompt identification and management of these children can prevent excessive short stature in adulthood. In addition, a thorough clinical assessment may allow evaluation of the severity of short stature and likely growth trajectory to identify the most effective interventions. Consequently, appropriate diagnosis of short stature should be performed as early as possible and personalized treatment should be started in a timely manner. An increase in knowledge and widespread availability of genetic and epigenetic testing in clinical practice in recent years has empowered the diagnostic process and appropriate treatment for short stature. Furthermore, novel treatment approaches that can be used both as diagnostic tools and as therapeutic agents have been developed. This article reviews the diagnostic approach to children with short stature, discusses the main causes of short stature in children, and reports current therapeutic approaches and possible future treatments.
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Affiliation(s)
- Nella Polidori
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | | | - Angelika Mohn
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti, Chieti, Italy,Address for correspondence: Francesco Chiarelli, MD, PhD Department of Pediatrics, University of Chieti, Via dei Vestini, 5, I-66100 Chieti, Italy Tel: +39-0871-358015 Fax: +39-0871-574538 E-mail:
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Jung MH, Suh BK, Ko CW, Lee KH, Jin DK, Yoo HW, Hwang JS, Chung WY, Han HS, Prusty V, Kim HS. Efficacy and Safety Evaluation of Human Growth Hormone Therapy in Patients with Idiopathic Short Stature in Korea - A Randomised Controlled Trial. EUROPEAN ENDOCRINOLOGY 2020; 16:54-59. [PMID: 32595770 PMCID: PMC7308103 DOI: 10.17925/ee.2020.16.1.54] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/07/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND This trial evaluated the efficacy and safety of growth hormone (GH) therapy (Norditropin®; Novo Nordisk, Bagsværd, Denmark) in paediatric patients with idiopathic short stature (ISS) in Korea. METHODS This was an open-label, parallel-group, multicentre, interventional trial (ClinicalTrials.gov identifier: NCT01778023). Pre-pubertal patients (mean age 6.2 years; height, 107.1 cm) were randomised 2:1 to 12 months' GH treatment (0.469 mg/kg/week; group A, n=36) or 6 months untreated followed by 6 months' GH treatment (group B, n=18). Safety analysis was based on adverse events (AEs) in all GH-treated patients. RESULTS After 6 months, height velocity (Ht-V), change in both height standard deviation score (Ht-SDS) and insulin-like growth factor 1 (mean difference [95% confidence interval {CI}]: 5.15 cm/year [4.09, 6.21]; 0.57 [0.43, 0.71]; 164.56 ng/mL [112.04, 217.08], respectively; all p<0.0001) were greater in group A than in group B. Mean difference in Ht-V for 0-6 months versus 6-12 months was 2.80 cm/year (95% CI 1.55, 4.04) for group A and -4.60 cm/year (95% CI -6.12, -3.09; both p<0.0001) for group B. No unexpected AEs were reported. CONCLUSIONS During the first 6 months, height was significantly increased in GH-treated patients versus untreated patients with ISS. Safety of GH was consistent with the known safety profile.
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Affiliation(s)
- Min Ho Jung
- The Catholic University of Korea, Yeouido St. Mary’s Hospital, Seoul, South Korea
| | - Byung-Kyu Suh
- The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, South Korea
| | - Cheol Woo Ko
- Kyungpook National University Hospital, Daegu, South Korea
| | | | - Dong-Kyu Jin
- Samsung Medical Center, Sung Kyun Kwan University, Seoul, South Korea
| | | | | | | | - Heon-Seok Han
- Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Vinay Prusty
- Novo Nordisk Pharma Gulf FZ-LLC, Dubai, United Arab Emirates
| | - Ho-Seong Kim
- Severance Hospital, Yonsei University Health System, Seoul, South Korea
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Alzahrani AK, Algethami AK, Barnawi G, Meftah IA, Alshanqiti A, Al-Hashmi H, Khan MA, Felimban N. Differences in Response to Recombinant Growth Hormone Therapy on Height Gain in Patients with Idiopathic Short Stature Vs. Patients with Growth Hormone Deficiency. Cureus 2020; 12:e7319. [PMID: 32313760 PMCID: PMC7164722 DOI: 10.7759/cureus.7319] [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] [Indexed: 11/05/2022] Open
Abstract
Objective The use of recombinant human growth hormone (rhGH) in patients with idiopathic short stature (ISS) has been an area of concern since some studies reported less desired effects of the drug in this group of patients as compared to patients with growth hormone deficiency (GHD). In addition, there were no studies addressing the effects of rhGH in Saudi children. Therefore, we conducted a retrospective study to observe the effects one year of treatment with rhGH on the mean height gain in patients with ISS and GHD. Methods This retrospective study took place at King Abdulaziz Medical City in Jeddah. The study subjects included two groups of patients (GHD vs ISS). Patients' files were reviewed from January 2000 to January 2018 using the following parameters: chronological age, bone age, height, weight, body mass index (BMI), insulin-like growth factor (IGF-1), growth hormone stimulation test, and growth velocity (GV). After one year of treatment, the height, weight, and BMI of the study subjects were monitored and assessed. Results The total number of patients was 55, 36 of which were diagnosed with GHD while 19 were diagnosed with ISS. The mean age of patients with GHD and ISS were 10.7±2.38 and 10.91±2.74 years, respectively. Both groups showed a significant increase in height. The initial height for patients with GHD was 125.26±12.27 cm, and they achieved a mean height of 134.231±12.88 cm after one year of treatment. For the other group, the initial height for ISS patients was 125.51±10.94 cm, and they achieved a mean height of 134.04±10.90 cm after one-year therapy. However, after the treatment, there was no significant difference in the height gain between GHD and ISS patients (134.231±12.88, 134.04±10.90, respectively, P=0.437). Conclusion The short-term use of rhGH has a potent and similar effect on increasing the height of both patients diagnosed with ISS as well as GHD.
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Affiliation(s)
- Ali K Alzahrani
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Ghassan Barnawi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ibraheem A Meftah
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ammar Alshanqiti
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Mohammed A Khan
- Medical Education, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Ahmed OG, Sakhr HM, Ali HM, Abdlsamiee L. Effect of circulating 25-hydroxyvitamin D and antioxidant capacity level on cognitive function parameters of children with idiopathic short stature. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2020. [DOI: 10.1186/s43054-020-0020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
An optimal level of vitamin D is necessary for normal bone growth. Recently, vitamin D has been linked to many neurological disorders, changes in antioxidant capacity levels, and cognitive function decline in old age; thus, the aim was to evaluate the effect of vitamin D and antioxidant levels on the cognitive function parameters of children with idiopathic short stature (ISS).
Results
A prospective case-control study was conducted with 60 primary school-aged children with ISS who were compared to 60 unrelated healthy age- and sex-matched children as a control group. A complete clinical evaluation; anthropometric measurements; neurocognitive function parameters using the Stanford-Binet test, fifth edition; vitamin D level; total antioxidant capacity (TAC); total oxidative stress (TOS); and oxidative stress index (OSI) were measured. A total of 83.3% of children with ISS had a vitamin D level < 30 ng/ml with significantly lower vitamin D levels than the control group. The TAC level was significantly lower in children with ISS than in healthy children. Children with ISS had an average level for all of the cognitive function parameters but a lower non-verbal IQ, full-scale IQ, fluid reasoning, knowledge, quantitative reasoning, and working memory than healthy controls. A positive correlation was found between vitamin D level and all anthropometric measurements, all IQ parameters, and TAC levels in the studied children. A positive correlation was found between TAC and all IQ parameters.
Conclusion
Vitamin D level and antioxidant capacity level have a major impact on cognitive function parameters in children with ISS.
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38
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Quitmann J, Bloemeke J, Dörr HG, Bullinger M, Witt S, Silva N. First-year predictors of health-related quality of life changes in short-statured children treated with human growth hormone. J Endocrinol Invest 2019; 42:1067-1076. [PMID: 30840207 DOI: 10.1007/s40618-019-01027-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/20/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Little attention has been directed towards examining the impact of predictors on change in health-related quality of life (HRQOL) within the course of growth hormone (GH) treatment in pediatric short stature. We aimed to assess changes in HRQOL and its sociodemographic, clinical and psychosocial predictors in children and adolescents diagnosed with growth hormone deficiency (GHD), and born short for gestational age (SGA) before and 12-month after start of GH treatment from the parents' perspective. Results were compared with an untreated group with idiopathic short stature (ISS). In this prospective multicenter study, 152 parents of children/adolescents (aged 4-18 years) provided data on their children's HRQOL at baseline and at 12-month follow-up. METHOD Repeated-measures multivariate analyses of covariance were performed to examine parent-reported HRQOL changes from baseline to 1-year after treatment and hierarchical linear regressions to identify the predictors of HRQOL changes. RESULTS Results showed that parents of children that were treated with GH report an increase in their children's HRQOL after 1 year. Changes in HRQOL were mostly explained by psychosocial predictors followed by sociodemographic and clinical variables. Specifically, the diagnosis SGA significantly predicted a greater increase in parent-reported HRQOL. Furthermore, a lower caregiving burden significantly predicted a decrease in parent-reported HRQOL. CONCLUSION In conclusion, a substantial percentage of explained variance in HRQOL relates to psychosocial and sociodemographic predictors. However, there appears to be other important factors that are predictors of HRQOL, which need to be determined in large, population-based samples.
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Affiliation(s)
- J Quitmann
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - J Bloemeke
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - H-G Dörr
- Division Paediatric Endocrinology, Hospital for Children and Adolescents, University Erlangen-Nürnberg, Erlangen, Germany
| | - M Bullinger
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - S Witt
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - N Silva
- Center for Psychosocial Medicine, Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Faculty of Psychology and Education Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
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Kang S, Kim YM, Lee JA, Kim DH, Lim JS. Early Menarche is a Risk Factor for Short Stature in Young Korean Females: An Epidemiologic Study. J Clin Res Pediatr Endocrinol 2019; 11:234-239. [PMID: 30604602 PMCID: PMC6745461 DOI: 10.4274/jcrpe.galenos.2018.2018.0274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To assess the association between age at menarche and adult height [and body mass index (BMI)] in young Korean females and also to investigate whether early menarche (<12 years) is a risk factor for short stature and obesity in young Korean females. METHODS Data on 1148 females aged 18-30 years and 612 mother (612 pairs of mothers and daughters) from the 6th Korea National Health and Nutrition Examination Survey (2013-2015) were analyzed. RESULTS Among 1148 females, 256 (22.3%) had early menarche. Their stature was approximately 0.445 cm shorter when menarche had occurred one year earlier. The prevalence of short stature (≤153 cm) and obesity (BMI ≥25) was higher in females with early menarche compared to those with later menarche (short stature: 10.5% vs 6.4%, obesity; 20.7% vs 13.1%, all p<0.001). In multivariate regression, the odds ratio (OR) for short stature was 2.62 [95% confidence interval (CI): 1.26-5.44] after adjusting for current age and mother’s height. OR for obesity was 1.74 (95% CI: 0.98-3.07) after adjusting for age and maternal BMI. CONCLUSION Final height in girls is influenced by age of menarche. Early menarche increased the risk for adult short stature in young Korean females.
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Affiliation(s)
- Sol Kang
- Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea
| | - Yoon Mo Kim
- Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea
| | - Jun Ah Lee
- Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea
| | - Dong Ho Kim
- Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea
| | - Jung Sub Lim
- Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea,* Address for Correspondence: Korea Cancer Center Hospital, Department of Pediatrics, Seoul, Republic of Korea Phone: +82-2-970-1224 E-mail:,
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Bullinger M, Bloemeke J, Mericq V, Sommer R, Gaete X, Ross JL, Yu YM, Permuy J, Gagliardi P, Damaso YL, Mauras N. Quality of Life in Adolescent Boys with Idiopathic Short Stature: Positive Impact of Growth Hormone and Aromatase Inhibitors. Horm Res Paediatr 2019; 90:381-392. [PMID: 30820008 DOI: 10.1159/000496353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/18/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The combination of growth hormone (GH) and aromatase inhibitors (AI) improves linear growth in severely short adolescent boys; however, the effects of this intervention on quality of life (QoL) are unknown. This study assesses whether GH, AI, or their combination impacts the QoL of adolescent males with idiopathic short stature (ISS) from both the adolescent and the parent perspective. METHOD A randomized open-label comparator trial was conducted in 76 pubertal males with ISS who received AI, GH, or AI/GH for 24 months. The condition-specific Quality of Life in Short Stature Youth questionnaire was used to assess QoL. RESULTS QoL scores were low at baseline in the children's and parents' reports. Within-group testing showed that total QoL scores increased significantly at 24 months in the GH and AI/GH group but not the AI group in the children's report, whereas it increased in all of the groups in the parents' report. Increases in QoL scores were associated with an increase in height SDS. CONCLUSIONS Treatment with GH and AI/GH was associated with improved QoL scores as measured from both the patients' and the parents' perspectives, suggesting that the improved growth resulting from the use of these growth-promoting therapies has beneficial psychosocial effects in adolescent males with ISS followed for 24 months.
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Affiliation(s)
| | | | - Veronica Mericq
- Division of Endocrinology, University of Santiago, Santiago, Chile
| | - Rachel Sommer
- University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Xiemena Gaete
- Division of Endocrinology, University of Santiago, Santiago, Chile
| | - Judith L Ross
- Division of Endocrinology, Nemours Children's Health System, Philadelphia, Pennsylvania, USA
| | - Y Miles Yu
- Division of Endocrinology, Nemours Children's Health System, Orlando, Florida, USA
| | - Joseph Permuy
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Priscila Gagliardi
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Y Ligeia Damaso
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Nelly Mauras
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
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Tang R, Lin L, Guo Z, Hou H, Yu Q. Ovarian reserve evaluation in a woman with 45,X/47,XXX mosaicism: A case report and a review of literature. Mol Genet Genomic Med 2019; 7:e00732. [PMID: 31070017 PMCID: PMC6625135 DOI: 10.1002/mgg3.732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/21/2019] [Accepted: 04/22/2019] [Indexed: 12/20/2022] Open
Abstract
Background Turner syndrome (TS) is a common chromosomal disorder affecting approximately 1:2,500 live female births. Mosaic 47,XXX karyotype is found in 3%–4% of TS patients. TS phenotype in rare 45,X/47,XXX mosaicism patients is milder than in classic TS, however their ovarian function, especially in the mature age, has not been described in detail. Methods A case report and literature review. Results A 30‐year‐old woman with menstrual irregularity and primary infertility presented with short stature and multiple nevi on the face without other common TS clinical features. She had spontaneous puberty and menarche but diminished ovarian reserve at the age of 30. Fluorescence in situ hybridization (FISH) indicated 45,X/47,XXX mosaicism, which was once misdiagnosed as 45,X monosomy. Literature review revealed the prevalence of short stature in only 64.3% of 45,X/47,XXX mosaicism cases, that is, much less frequently than in pure 45,X monosomy. The risk of premature ovarian insufficiency in 45,X/47,XXX mosaicism patients is higher, and ovarian failure is usually observed at around 30 years of age. Conclusion FISH should be recommended to evaluate low proportion mosaicism in similar cases. Due to the risk of ovarian failure, fertility preservation for patients with 45,X/47,XXX mosaicism at a younger age must be considered.
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Affiliation(s)
- Ruiyi Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Lin Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China.,Department of Obstetrics and Gynecology, The Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi, People's Republic of China
| | - Zaixin Guo
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Haiyan Hou
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China.,Obstetrics and Gynecology, Characteristic Medical Center of PAP, Tianjin, People's Republic of China
| | - Qi Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
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Storr HL, Chatterjee S, Metherell LA, Foley C, Rosenfeld RG, Backeljauw PF, Dauber A, Savage MO, Hwa V. Nonclassical GH Insensitivity: Characterization of Mild Abnormalities of GH Action. Endocr Rev 2019; 40:476-505. [PMID: 30265312 PMCID: PMC6607971 DOI: 10.1210/er.2018-00146] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/31/2018] [Indexed: 12/12/2022]
Abstract
GH insensitivity (GHI) presents in childhood with growth failure and in its severe form is associated with extreme short stature and dysmorphic and metabolic abnormalities. In recent years, the clinical, biochemical, and genetic characteristics of GHI and other overlapping short stature syndromes have rapidly expanded. This can be attributed to advancing genetic techniques and a greater awareness of this group of disorders. We review this important spectrum of defects, which present with phenotypes at the milder end of the GHI continuum. We discuss their clinical, biochemical, and genetic characteristics. The objective of this review is to clarify the definition, identification, and investigation of this clinically relevant group of growth defects. We also review the therapeutic challenges of mild GHI.
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Affiliation(s)
- Helen L Storr
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Sumana Chatterjee
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Louise A Metherell
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Corinne Foley
- Division of Endocrinology, Cincinnati Center for Growth Disorders, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ron G Rosenfeld
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Philippe F Backeljauw
- Division of Endocrinology, Cincinnati Center for Growth Disorders, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Andrew Dauber
- Division of Endocrinology, Cincinnati Center for Growth Disorders, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Vivian Hwa
- Division of Endocrinology, Cincinnati Center for Growth Disorders, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Yang L, Zhang C, Wang W, Wang J, Xiao Y, Lu W, Ma X, Chen L, Ni J, Wang D, Shi J, Dong Z. Pathogenic gene screening in 91 Chinese patients with short stature of unknown etiology with a targeted next-generation sequencing panel. BMC MEDICAL GENETICS 2018; 19:212. [PMID: 30541462 PMCID: PMC6292044 DOI: 10.1186/s12881-018-0730-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/28/2018] [Indexed: 12/27/2022]
Abstract
Background Dwarfism is a common severe growth disorder, but the etiology is unclear in the majority of cases. Recombinant human growth hormone may be a treatment option, but it has limited efficacy. The currently known laboratory assays do not meet the precision requirements for clinical diagnosis. Here, we have constructed a targeted next-generation sequencing (NGS) panel of selected genes that are suspected to be associated with dwarfism for genetic screening. Methods Genetic screening of 91 children with short stature of unknown etiology was performed with the help of the NGS panel. All the coding regions and exon-intron boundaries of 166 genes were included in the panel. To clarify the pathogenicity of these mutations, their clinical data were reviewed and analyzed. Results The assay identified p.A72G, p.I282V, and p.P491S variants of the PTPN11 gene and a p.I437T variant of the SOS1 gene in 4 cases with Noonan syndrome. A frameshift mutation (p.D2407fs) of the ACAN gene was identified in a case of idiopathic short stature with moderately advanced bone age. A p.R904C variant of the COL2A1 gene was found in a patient, who was accordingly diagnosed with Stickler syndrome. Severe short stature without limb deformity was associated with a p.G11A variant of HOXD13. In addition, we evaluated evidence that a p.D401N variant of the COMP gene may cause multiple epiphyseal dysplasia. Conclusions Our findings suggest that syndromes, particularly Noonan syndrome, may be overlooked due to atypical clinical features. This gene panel has been verified to be effective for the rapid screening of genetic etiologies associated with short stature and for guiding precision medicine-based clinical management.
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Affiliation(s)
- Lulu Yang
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Chenhui Zhang
- Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute (SITI), Keyuan Road 1278, Shanghai, 201203, China
| | - Wei Wang
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Junqi Wang
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Yuan Xiao
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Wenli Lu
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Xiaoyu Ma
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Lifen Chen
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Jihong Ni
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Defen Wang
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Jinxiu Shi
- Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute (SITI), Keyuan Road 1278, Shanghai, 201203, China.
| | - Zhiya Dong
- Department of Pediatrics, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China.
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van der Sluijs PJ, Jansen S, Vergano SA, Adachi-Fukuda M, Alanay Y, AlKindy A, Baban A, Bayat A, Beck-Wödl S, Berry K, Bijlsma EK, Bok LA, Brouwer AFJ, van der Burgt I, Campeau PM, Canham N, Chrzanowska K, Chu YWY, Chung BHY, Dahan K, De Rademaeker M, Destree A, Dudding-Byth T, Earl R, Elcioglu N, Elias ER, Fagerberg C, Gardham A, Gener B, Gerkes EH, Grasshoff U, van Haeringen A, Heitink KR, Herkert JC, den Hollander NS, Horn D, Hunt D, Kant SG, Kato M, Kayserili H, Kersseboom R, Kilic E, Krajewska-Walasek M, Lammers K, Laulund LW, Lederer D, Lees M, López-González V, Maas S, Mancini GMS, Marcelis C, Martinez F, Maystadt I, McGuire M, McKee S, Mehta S, Metcalfe K, Milunsky J, Mizuno S, Moeschler JB, Netzer C, Ockeloen CW, Oehl-Jaschkowitz B, Okamoto N, Olminkhof SNM, Orellana C, Pasquier L, Pottinger C, Riehmer V, Robertson SP, Roifman M, Rooryck C, Ropers FG, Rosello M, Ruivenkamp CAL, Sagiroglu MS, Sallevelt SCEH, Sanchis Calvo A, Simsek-Kiper PO, Soares G, Solaeche L, Sonmez FM, Splitt M, Steenbeek D, Stegmann APA, Stumpel CTRM, Tanabe S, Uctepe E, Utine GE, Veenstra-Knol HE, Venkateswaran S, Vilain C, Vincent-Delorme C, Vulto-van Silfhout AT, Wheeler P, Wilson GN, Wilson LC, Wollnik B, Kosho T, Wieczorek D, Eichler E, Pfundt R, de Vries BBA, Clayton-Smith J, Santen GWE. The ARID1B spectrum in 143 patients: from nonsyndromic intellectual disability to Coffin-Siris syndrome. Genet Med 2018; 21:1295-1307. [PMID: 30349098 PMCID: PMC6752273 DOI: 10.1038/s41436-018-0330-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/26/2018] [Indexed: 01/09/2023] Open
Abstract
Purpose Pathogenic variants in ARID1B are one of the most frequent causes of intellectual disability (ID) as determined by large-scale exome sequencing studies. Most studies published thus far describe clinically diagnosed Coffin–Siris patients (ARID1B-CSS) and it is unclear whether these data are representative for patients identified through sequencing of unbiased ID cohorts (ARID1B-ID). We therefore sought to determine genotypic and phenotypic differences between ARID1B-ID and ARID1B-CSS. In parallel, we investigated the effect of different methods of phenotype reporting. Methods Clinicians entered clinical data in an extensive web-based survey. Results 79 ARID1B-CSS and 64 ARID1B-ID patients were included. CSS-associated dysmorphic features, such as thick eyebrows, long eyelashes, thick alae nasi, long and/or broad philtrum, small nails and small or absent fifth distal phalanx and hypertrichosis, were observed significantly more often (p < 0.001) in ARID1B-CSS patients. No other significant differences were identified. Conclusion There are only minor differences between ARID1B-ID and ARID1B-CSS patients. ARID1B-related disorders seem to consist of a spectrum, and patients should be managed similarly. We demonstrated that data collection methods without an explicit option to report the absence of a feature (such as most Human Phenotype Ontology-based methods) tended to underestimate gene-related features.
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Affiliation(s)
| | - Sandra Jansen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Samantha A Vergano
- Division of Medical Genetics and Metabolism, Children's Hospital of the King's Daughters, Norfolk, VA, USA
| | - Miho Adachi-Fukuda
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yasemin Alanay
- School of Medicine, Department of Pediatrics, Pediatric Genetics Unit, Acibadem University, Istanbul, Turkey
| | - Adila AlKindy
- Department of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
| | - Anwar Baban
- Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children Hospital and Research Institute, IRCCS, Rome, Italy
| | - Allan Bayat
- Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - Stefanie Beck-Wödl
- Department of Molecular Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Katherine Berry
- Department of Medical Genetics, Shodair Hospital, Helena, MT, USA
| | - Emilia K Bijlsma
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Levinus A Bok
- Department of Pediatrics, Màxima Medical Centre, Veldhoven, The Netherlands
| | - Alwin F J Brouwer
- Department of Paediatrics, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - Ineke van der Burgt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Philippe M Campeau
- Department of Pediatrics, CHU Sainte-Justine and University of Montreal, Montreal, QC, Canada
| | - Natalie Canham
- North West Thames Regional Genetics Service, Northwick Park Hospital, Harrow, United Kingdom.,Cheshire and Merseyside Regional Genetics Service, Liverpool Women's Hospital, Crown Street, Liverpool, United Kingdom
| | - Krystyna Chrzanowska
- Department of Medical Genetics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Yoyo W Y Chu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Brain H Y Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Karin Dahan
- Center for Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | | | - Anne Destree
- Center for Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | - Tracy Dudding-Byth
- Hunter Genetics and University of Newcastle, GrowUpWell Priority Research Centre, Newcastle, Australia
| | - Rachel Earl
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Nursel Elcioglu
- Department of Pediatric Genetics, Marmara University Pendik Hospital, Istanbul, Turkey
| | - Ellen R Elias
- Department of Pediatrics and Genetics, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Christina Fagerberg
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Alice Gardham
- North West Thames Regional Genetics Service, Northwick Park Hospital, Harrow, United Kingdom
| | - Blanca Gener
- Department of Genetics, Cruces University Hospital, Biocruces Health Research Institute, Vizcayam, Spain
| | - Erica H Gerkes
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Ute Grasshoff
- Department of Molecular Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Arie van Haeringen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin R Heitink
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna C Herkert
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | | | - Denise Horn
- Institute for Medical Genetics and Human Genetics, Charité Universitätsmedizin, Berlin, Germany
| | - David Hunt
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Sarina G Kant
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Hülya Kayserili
- Medical Genetics Department, Koç University School of Medicine (KUSoM), İstanbul, Turkey
| | - Rogier Kersseboom
- Department of Clinical Genetics, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands
| | - Esra Kilic
- Department of Pediatric Genetics, Hematology Oncology Research & Training Children's Hospital, Ankara, Turkey
| | | | - Kylin Lammers
- Department of Medical Genetics, Dayton Children's Hospital, Dayton, OH, USA
| | - Lone W Laulund
- Department of Paediatrics, Odense University Hospital, Odense, Denmark
| | - Damien Lederer
- Center for Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | - Melissa Lees
- Department of Clinical Genetics, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Vanesa López-González
- Sección de Genética Médica, Servicio de Pediatria, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERER-ISCIII, Murcia, Spain
| | - Saskia Maas
- Department of Clinical Genetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Grazia M S Mancini
- Department of Clinical Genetics, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands
| | - Carlo Marcelis
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Francisco Martinez
- Unidad de Genética, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Isabelle Maystadt
- Center for Human Genetics, Institute of Pathology and Genetics, Gosselies, Belgium
| | - Marianne McGuire
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA
| | - Shane McKee
- Northern Ireland Regional Genetics Centre, Belfast City Hospital, Belfast, Ireland
| | - Sarju Mehta
- East Anglian Regional Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Kay Metcalfe
- Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | | | - Seiji Mizuno
- Department of Pediatrics, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan
| | - John B Moeschler
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Christian Netzer
- Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany
| | - Charlotte W Ockeloen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Sharon N M Olminkhof
- Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Carmen Orellana
- Unidad de Genética, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Laurent Pasquier
- CRMR Déficiences intellectuelles, Service de Génétique Médicale, CLAD Ouest CHU Hôpital Sud, Rennes, France
| | - Caroline Pottinger
- All Wales Medical Genetics Service, Glan Clwyd Hospital, Rhyl, United Kingdom
| | - Vera Riehmer
- Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany
| | | | - Maian Roifman
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON, Canada
| | | | - Fabienne G Ropers
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Monica Rosello
- Unidad de Genética, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Claudia A L Ruivenkamp
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Suzanne C E H Sallevelt
- Department of Clinical Genetics and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Pelin O Simsek-Kiper
- Department of Pediatric Genetics, Ihsan Dogramaci Children's Hospital, Hacettepe University School of Medicine, Ankara, Turkey
| | - Gabriela Soares
- Jacinto de Magalhães Medical Genetics Center, Centro Hospitalar do Porto, Porto, Portugal
| | - Lucia Solaeche
- Departamento de neurometabólicas, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Fatma Mujgan Sonmez
- Karadeniz Technical University, Faculty of Medicine, Dept of Child Neurology, Retired Professor, Trabzon, Turkey
| | - Miranda Splitt
- Northern Genetics Service, Institute of Genetics Medicine, Newcastle upon Tyne, United Kingdom
| | - Duco Steenbeek
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexander P A Stegmann
- Department of Clinical Genetics and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Constance T R M Stumpel
- Department of Clinical Genetics and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Saori Tanabe
- Division of Pediatrics, Yamagata Prefectural and Sakata Munici pal Hospital Organization Nihon-Kai General Hospital, Sakata, Japan
| | | | - G Eda Utine
- Department of Pediatric Genetics, Ihsan Dogramaci Children's Hospital, Hacettepe University School of Medicine, Ankara, Turkey
| | - Hermine E Veenstra-Knol
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Sunita Venkateswaran
- Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Catheline Vilain
- Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB Center of Medical Genetics, Université Libre de Bruxelles, Brussels, Belgium.,Department of Genetics, Hôpital Erasme. ULB Center of Medical Genetics, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Anneke T Vulto-van Silfhout
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Golder N Wilson
- KinderGenome Genetics, Medical City Hospital Dallas, Dallas, TX, USA
| | - Louise C Wilson
- Department of Clinical Genetics, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Bernd Wollnik
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Tomoki Kosho
- Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan
| | - Dagmar Wieczorek
- Institute of Human Genetics, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Evan Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Rolph Pfundt
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bert B A de Vries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jill Clayton-Smith
- Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Gijs W E Santen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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Kaplan DS, Canak A, Isık E, Orkmez M, Kumru B. Relationship of fibroblast growth factor 21, sirtuin 1, visfatin, and regulators in children with short stature. Growth Factors 2018; 36:172-177. [PMID: 30304969 DOI: 10.1080/08977194.2018.1513504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Fibroblast growth factor 21 (FGF21) is mainly secreted by the liver. It is a factor that is not fully understood in relation to growth. Sirtuin 1 (SIRT1) is a deacetylase protein. It is thought that may have an effect on the release and function of GH and IGF-1. Visfatin is synthesized from adipose tissue as primary. It may be prognostic marker associated with growth factors. As a result of our work, FGF21 is not associated with short stature but levels of SIRT1 and visfatin are associated with short stature. The decrease in visfatin value in the short-stature group is thought to be due to an insufficient amount of adipose tissue, which is important for growth and development. SIRT1 might decrease GH effect by increasing STAT5 deacetylation in the liver and we think that the result of this reduction of SIRT1 would negatively impact IGF-1 and IGFBP-3 production.
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Affiliation(s)
- Davut Sinan Kaplan
- a Medical Faculty, Department of Physiology, Health Sciences Institution , University of Gaziantep , Gaziantep , Turkey
| | - Asuman Canak
- a Medical Faculty, Department of Physiology, Health Sciences Institution , University of Gaziantep , Gaziantep , Turkey
| | - Emregul Isık
- b The Polyclinic Child Endocrinology , Gaziantep Cengiz Gökcek Maternity and Children's Hospital , Gaziantep , Turkey
| | - Mustafa Orkmez
- c Medical Faculty, Department of Medical Biochemistry, Health Sciences Institution , University of Gaziantep , Gaziantep , Turkey
| | - Burcu Kumru
- d Nutritionist, Division of Nutrition and Diet , Gaziantep Cengiz Gökcek Maternity and Children's Hospital , Gaziantep , Turkey
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Murray PG, Clayton PE, Chernausek SD. A genetic approach to evaluation of short stature of undetermined cause. Lancet Diabetes Endocrinol 2018; 6:564-574. [PMID: 29397377 DOI: 10.1016/s2213-8587(18)30034-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 11/22/2017] [Accepted: 12/02/2017] [Indexed: 12/15/2022]
Abstract
Short stature is a common presentation to paediatric endocrinologists. After exclusion of major endocrine or systemic disease, most children with short stature are diagnosed based on a description of their growth pattern and the height of their parents (eg, familial short stature). Height is a polygenic trait and genome-wide association studies have identified many of the associated genetic loci. Here we review the application of genetic studies, including copy number variant analysis, targeted gene panels, and whole-exome sequencing in children with idiopathic short stature. We estimate 25-40% of children diagnosed with idiopathic short stature could receive a molecular diagnosis using these technologies. A molecular diagnosis for short stature is important for affected individuals and their families and might inform treatment decisions surrounding use of growth hormone or insulin-like growth factor 1 therapy.
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Affiliation(s)
- Philip G Murray
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK
| | - Peter E Clayton
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK
| | - Steven D Chernausek
- Diabetes and Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Van Kalleveen MW, de Meij T, Plötz FB. Clinical spectrum of paediatric coeliac disease: a 10-year single-centre experience. Eur J Pediatr 2018; 177:593-602. [PMID: 29392394 DOI: 10.1007/s00431-018-3103-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 02/07/2023]
Abstract
UNLABELLED This study was undertaken to gain insight in the clinical spectrum of paediatric coeliac disease (CD) in a Dutch teaching hospital. We retrospectively compared the frequency of CD in children with a wide spectrum of complaints with and without CD antibodies in serum and were interested if certain complaints are more pathognomonic for CD. Furthermore, we expected that over a period of 10-year incidence rates of CD would have increased and shifted towards an atypical presentation with more non-gastrointestinal symptoms with increasing age. A retrospective, single-centre, case-control study was performed. All patients who presented at the Department of Paediatrics, Tergooi Hospital, with symptoms suspected for CD were eligible for inclusion during the study period from 1 January 2007 till 31 December 2016. Children were diagnosed with CD according to the 2005 and 2012 ESPGHAN guideline between 2007 and 2016, respectively. Demographic data, presenting symptoms, prevalence of associated conditions and serology results were examined. A total of 105 new cases of paediatric CD were observed, with an average of 10 new cases each year. The calculated incidence was 21.09 (CI 17.49-25.22)/100,000 under 18 years of age. About 40% were infants and toddlers, predominantly presenting with gastrointestinal symptoms. Primary and high school children had more display of atypical symptoms (p = 0.001, p = 0.017) and non-gastrointestinal symptoms (p = 0.009, p = 0.009) than infants and toddlers. In 8.6% of the CD patients, mostly primary school aged female patients, the serology was repeated at least once in time to become positive. The median time for serology to become positive was 609 days (range 140-1054). CONCLUSION As it is well known, our study supports the increasing notion of a shift in the clinical spectrum of presenting symptoms in paediatric CD towards an atypical presentation, with more non-gastrointestinal symptoms and a diagnosis at a later age in a Dutch population, whereas the number of new cases did not increase over the years. What is Known: • The clinical spectrum of paediatric coeliac disease is shifting towards a presentation with more atypical and non-GI symptoms. • The incidence of paediatric coeliac disease is still increasing as is the age at which it is diagnosed. What is New: • An average of 10 paediatric CD cases are diagnosed per year in our general teaching hospital. • The calculated (gender-specific) incidence rates are higher than previously reported.
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Affiliation(s)
- Michael W Van Kalleveen
- Department of Paediatrics, Tergooi Hospital, Rijksstraatweg 1, 1261 AN, Blaricum, The Netherlands.
| | - Tim de Meij
- Department of Paediatric Gastroenterology, VU Medical Centre (VUmc), Amsterdam, The Netherlands
| | - Frans B Plötz
- Department of Paediatrics, Tergooi Hospital, Rijksstraatweg 1, 1261 AN, Blaricum, The Netherlands
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48
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Mreish S, Kaplan W, Chedid F. Effect of Growth Hormone on Final Height in Children with Idiopathic Short Stature: A UAE, Eastern Region Experience. Oman Med J 2017; 32:467-470. [PMID: 29218122 DOI: 10.5001/omj.2017.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives The use of growth hormone (GH) in idiopathic short stature (ISS) has been a subject of debate for the past two decades. We sought to assess the effect of GH on final height (FH) in patients with ISS in our region, which has a high consanguinity rate, and compare it to the effect observed in GH deficient (GHD) patients. Methods We conducted a retrospective chart review from 1 January 2005 to 31 December 2013 for patients with ISS or GHD from the local United Arab Emirates population who received GH treatment and were followed-up regularly in our clinic. The change in height Z-score at 12 months and FH were assessed within each group and between the two groups. Results Twenty-one patients with ISS and 29 patients with GHD were studied. There was a significant change in height Z-score at 12 months and FH in both groups (p < 0.001). The improvement in the ISS group was comparable to the response seen in GHD patients at 12 months (0.5±0.3 standard deviation score (SDS), and 0.5±0.4 SDS, respectively; p = 0.540). The effect on FH was better in ISS group than the GHD group of all etiologies (1.3±0.6 SDS vs. 0.9±0.7 SDS, respectively; p = 0.050), there was no difference between the ISS and the subgroup of idiopathic GHD (1.3±0.5 SDS and 1.2±0.8 SDS, respectively). Conclusions In our local population, GH has a positive effect on the short-term growth and FH of children with ISS to the same extent that has been observed in children with idiopathic GH deficiency.
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Affiliation(s)
- Shireen Mreish
- Division of Endocrinology, Department of Pediatric, Tawam Hospital, Al Ain, UAE
| | - Walid Kaplan
- Division of Endocrinology, Department of Pediatric, Tawam Hospital, Al Ain, UAE
| | - Fares Chedid
- Division of Neonatology, Department of Pediatric, Al Jalila Children's Specialty Hospital, Dubai, UAE
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Abstract
Growth hormone (GH) was first isolated from cadaver pituitary glands, requiring laborious and expensive collection of glands, followed by extraction and purification of the hormone. This limited supply restricted its use to children with severe GH deficiency who were treated with low dosages and suboptimal schedules. The development of recombinant DNA-derived GH, allowed the production of virtually unlimited amounts of GH, leading to the approval for therapy for a large number of childhood conditions characterized by non-GH deficient short stature. The aim of this review is to provide a critical overview on the daily use of GH in two paradigmatic conditions of non-GH deficient short stature which are children born small for gestational age and with idiopathic short stature, highlighting the available strength of evidence for efficacy and safety.
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Affiliation(s)
- Annalisa Deodati
- University of Rome Tor Vergata, Bambino Gesù Children’s Hospital, Dipartimento di Pediatria Universitario Ospedaliero, Rome, Italy
| | - Stefano Cianfarani
- University of Rome Tor Vergata, Bambino Gesù Children’s Hospital, Dipartimento di Pediatria Universitario Ospedaliero, Rome, Italy
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Karolinska Institutet, Department of Women’s and Children’s Health, Stockholm, Sweden
,* Address for Correspondence: Bambino Gesù Children’s Hospital, Dipartimento di Pediatria Universitario Ospedaliero, Rome, Italy Phone: +39 06 6859 3074 E-mail:
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Li G, Li N, Li J, Ding Y, Yu T, Wang X, Wang J. De Novo Mutation of KAT6B Gene Causing Atypical Say-Barber-Biesecker-Young-Simpson Syndrome or Genitopatellar Syndrome. Fetal Pediatr Pathol 2017; 36:130-138. [PMID: 28426343 DOI: 10.1080/15513815.2017.1281364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mutations in KAT6B gene are responsible for Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS) and genitopatellar syndrome (GPS), with most mutations occurring in exon 18. A 4-year-old Chinese boy presented with short stature but no other clinical features of SBBYSS or GPS had a de novo novel nonsense pathogenic mutation in exon 14 of the KAT6B gene at position c.2636T>A (p.Leu879X). The correlation analysis of genotype-phenotype indicated distinctive clinical features (short stature, growth hormone deficiency, and delayed bone age) compared with the classical mutations of KAT6B gene. To the best of our knowledge, this is the first report of KAT6B gene mutation in any Chinese individual. This work expands the mutant phenotypic spectrum of the KAT6B gene.
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Affiliation(s)
- Guoqiang Li
- a Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China.,b Department of Medical Genetics , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Niu Li
- b Department of Medical Genetics , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Juan Li
- c Department of Endocrinology , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Yu Ding
- c Department of Endocrinology , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Tingting Yu
- a Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Xiumin Wang
- b Department of Medical Genetics , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China.,c Department of Endocrinology , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Jian Wang
- a Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China.,b Department of Medical Genetics , Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine , Shanghai , China
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