title: Effects on growth and body composition of growth hormone treatment in children with juvenile idiopathic arthritis requiring steroid therapy.
abstract: OBJECTIVE
  Decreased growth velocity and abnormal body composition including severe osteoporosis are common in glucocorticoid-treated patients with juvenile idiopathic arthritis (JIA). We evaluated the effects of recombinant human growth hormone (GH) given for 3 years on growth velocity, height standard deviation score (SDS), and body composition, together with potential adverse effects on glucose tolerance.
  
  
  METHODS
  Thirteen patients received GH (0.46 mg/kg/week) for 3 years. Body composition was assessed by dual-energy x-ray absorptiometry and glucose tolerance by annual oral glucose tolerance tests.
  
  
  RESULTS
  Median growth velocity increased from 2.1 to 6.0 cm/year (p = 0.002) in the first year and remained higher than baseline in the second year of treatment. Height SDS did not change significantly (-4.6 SDS at baseline vs -4.3 SDS at study completion), but the growth response varied markedly across patients. Compared with baseline, lean mass increased by 33%, fat mass remained stable, and lumbar bone mineral density increased by 36.6%. Transient glucose intolerance developed in 6 patients, but glycosylated hemoglobin concentrations did not change significantly and diabetes mellitus did not occur.
  
  
  CONCLUSIONS
  Treatment with GH restored linear growth without inducing catch-up growth, significantly improved body composition, and prevented further bone loss. Prolonged followup is needed to assess the benefits of GH and longterm consequences of hyperinsulinism.
authors.affiliation: Department of Endocrinology and Diabetology, Robert Debré Teaching Hospital, 48 Boulevard Sérurier, 75019 Paris, France. dominique.simon@rdb.ap-hop-paris.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Simon
authors.forename: Nadine
authors.initials: N
authors.lastname: Lucidarme
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Prieur
authors.forename: Jean Charles
authors.initials: JC
authors.lastname: Ruiz
authors.forename: Paul
authors.initials: P
authors.lastname: Czernichow
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D001823:Body Composition / Q000187:drug effects; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D018149:Glucose Intolerance / Q000209:etiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006128:Growth / Q000187:drug effects; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008159:Lumbar Vertebrae / Q000378:metabolism; D008297:Male; D013256:Steroids / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D013256:Steroids