Consequences of stopping growth hormone (GH) therapy in young GH deficient patients with childhood onset disease.
Many studies have shown the beneficial, anabolic effects of growth hormone (GH) replacement therapy in GH deficient adults with childhood onset or adult onset disease. It is becoming increasingly evident, however, that these two groups of patients differ in many respects. Patients with adult onset GH deficiency represent fully developed individuals who have various organic, cerebral defects. By contrast, patients with childhood onset disease represent a heterogenous group comprising individuals with conditions, such as idiopathic isolated GH deficiency, genetic defects and organic defects. It is generally accepted that all children treated with GH should be retested in adulthood before adult replacement is started, as around 40% have a normal retest. It is unclear whether continued treatment with GH in childhood onset GH deficiency will yield results as positive as those seen in trials where GH is re-instituted after longer periods without treatment. Similarly, it is unknown at what timepoint cessation of GH treatment will cause a worsening in the physical state of the patient. In our placebo-controlled trial where GH was discontinued in 19 patients treated with GH during childhood, we determined exercise capacity, body composition, muscle mass and strength, cardiac function, sweating capacity, thyroid function and glucose metabolism before and after 12 months of continued treatment with GH.
Juul
A
A
Department of Growth and Reproduction, State University Hospital, University of Copenhagen, Denmark.
Vahl
N
N
Jørgensen
J O
JO
Christiansen
J S
JS
Sneppen
S B
SB
Feldt-Rasmussen
U
U
Skakkebaek
N E
NE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001823:Body Composition / Q000187:drug effects; D004393:Dwarfism, Pituitary / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006321:Heart / Q000187:drug effects; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects; D010919:Placebos; D012737:Sex Factors; D013546:Sweating / Q000187:drug effects; D013961:Thyroid Gland / Q000187:drug effects
D010919:Placebos; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D000469:Alkaline Phosphatase; D005947:Glucose