Treatment of short normal children with growth hormone--a cautionary tale?
41 short normal children were randomly allocated either to daily injections of growth hormone (rhGH) at 30 IU/m2 per week or to no treatment. 6 months of rhGH therapy produced up to 76% loss of fat mass and up to 25% increase in lean body mass (LBM). These changes were significantly different from those in the untreated group. LBM was the main determinant of resting energy expenditure (REE) expressed as kJ/24 h. REE expressed as kJ/kg LBM per 24 h correlated negatively with height, which was responsible for 66% of the variance in REE kJ/kg LBM per 24 h. Short children therefore expend more energy than tall children in fulfilling basic metabolic needs. After 6 months REE kJ/24 h increased significantly in treated children. However, treated children did not differ significantly from untreated children in REE kJ/kg LBM per 24 h. rhGH does not therefore seem to have a specific effect upon REE. The possibility that rhGH produces profound metabolic effects should limit its use in otherwise healthy children until the mechanism of action is more clearly elucidated.
Walker
J M
JM
Department of Paediatrics, Southampton General Hospital, UK.
Bond
S A
SA
Voss
L D
LD
Betts
P R
PR
Wootton
S A
SA
Jackson
A A
AA
D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002648:Child; D004334:Drug Administration Schedule; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006128:Growth / Q000187:drug effects*; D013006:Growth Hormone / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007279:Injections, Subcutaneous; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology
D011994:Recombinant Proteins; D013006:Growth Hormone