Amino-terminal propeptide of C-type natriuretic peptide and linear growth in children: effects of puberty, testosterone, and growth hormone.
BACKGROUND
C-type natriuretic peptide (CNP), a paracrine factor of the growth plate, plays a key role in stimulating bone growth. The amino-terminal propeptide of CNP (NTproCNP) is produced in equimolar amounts with CNP and is measurable in plasma, providing a potential biomarker for growth plate activity and, hence, linear growth.


OBJECTIVE
We explored the effects of puberty, testosterone, and GH treatment on NTproCNP levels in normal and short-statured children.


METHODS
This was a retrospective analysis of samples obtained during previous studies.


METHODS
The study was conducted at a pediatric clinical research center.


METHODS
Children with short stature due to GH deficiency, idiopathic short stature (ISS), or constitutional delay of growth and maturation (CDGM) were studied (n = 37). A cohort of normal-statured adolescent boys was also studied (n = 23).


METHODS
Children with GH deficiency and ISS were studied before and during testosterone and/or GH treatment. Boys with CDGM and healthy controls were studied once.


METHODS
The main outcomes were NTproCNP levels before and during growth-promoting therapy and during pubertal growth.


RESULTS
Children with short stature due to GH deficiency, ISS, or CDGM had comparable baseline levels of NTproCNP, and levels increased markedly in response to GH or testosterone treatment. In boys with CDGM, levels were comparable with height-matched controls but were less than those from age-matched controls. In healthy boys, NTproCNP appears to peak with the pubertal growth spurt.


CONCLUSIONS
NTproCNP levels increase during growth-promoting therapy and are increased during puberty in boys. This novel biomarker of growth may have clinical utility in the evaluation of children with short stature and for monitoring growth-promoting therapy.
Division of Pediatric Endocrinology, Nemours Children's Clinic-Jacksonville, Jacksonville, Florida 32207, USA. rolney@nemours.org
Robert C
RC
Olney
Timothy C R
TC
Prickett
Timothy G
TG
Yandle
Eric A
EA
Espiner
Joan C
JC
Han
Nelly
N
Mauras
D000293:Adolescent; D000886:Anthropometry; D001823:Body Composition / Q000187:drug effects / Q000502:physiology; D001827:Body Height / Q000502:physiology; D015331:Cohort Studies; D004734:Energy Metabolism / Q000187:drug effects / Q000502:physiology; D005837:Genitalia, Male / Q000254:growth & development; D006128:Growth / Q000502:physiology*; D013006:Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011506:Proteins / Q000378:metabolism; D011627:Puberty / Q000097:blood*; D012727:Sex Characteristics; D013739:Testosterone / Q000009:adverse effects / Q000627:therapeutic use*
D010446:Peptide Fragments; D011506:Proteins; D019382:Human Growth Hormone; D020098:Natriuretic Peptide, C-Type; D013739:Testosterone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone