title: Growth hormone reserve in adult beta thalassemia patients.
abstract: Reduced serum insulin-like growth factor-1 (IGF-1) and hypogonadotrophic hypogonadism are common features of adult beta-thalassemia, and warrant evaluation of the growth hormone (GH)-IGF-1 axis. The aim of this study was to determine GH reserve in beta-thalassemia patients (9 females, 7 males, 15 major, 1 intermedia), age 29.3 +/- 6.9 years, BMI 21.3 +/- 1.9 kg/m2, and in 20 age, sex and BMI-matched healthy controls, using the GH-releasing hormone (GHRH)-arginine test. The associations between peak GH response and hormonal and biochemical indices were evaluated. Using BMI-related cut-off limits for peak GH response in the GHRH-arginine test, 4/16 beta-thalassemia patients had peak GH lower than 11.5 microg/l, the cut-off limit suggested for lean subjects, and were diagnosed as GH deficient (GHD). Using 9 microg/l as the cut-off limit 2/16 patients were GHD. Reduced serum IGF-1 and IGFBP-3 were present in 69% and 19% of the patients, respectively. Peak GH did not correlate with serum IGF-1, TSH, and fT4 levels or gonadal status. Neither peak GH nor IGF-1 correlated with serum ferritin. Our findings suggest that GHD is present in up to a quarter of adult beta-thalassemia patients. The clinical benefits of GH therapy need to be determined. GHD alone does not account for the high prevalence of reduced IGF-1 in adult beta-thalassemia.
authors: Hebrew University-Hadassah Medical School, Jerusalem, 91120, Israel.
authors: Guy
authors: G
authors: Vidergor
authors: Ada W
authors: AW
authors: Goldfarb
authors: Benjamin
authors: B
authors: Glaser
authors: Rivka
authors: R
authors: Dresner-Pollak
mesh_terms: D000328:Adult; D001120:Arginine; D016022:Case-Control Studies; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D013007:Growth Hormone-Releasing Hormone; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017086:beta-Thalassemia / Q000097:blood*
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D001120:Arginine
references: Endocrine. 2001 Jun;15(1):29-38
references: 11572322
references: J Hepatol. 2002 Jun;36(6):751-8
references: 12044524
references: Br J Haematol. 2004 Oct;127(2):127-39
references: 15461618
references: Br J Haematol. 2000 Dec;111(3):902-7
references: 11122154
references: J Clin Endocrinol Metab. 1998 May;83(5):1615-8
references: 9589665
references: J Endocrinol Invest. 2003 Jul;26(7):623-8
references: 14594112
references: J Pediatr Endocrinol Metab. 1998;11 Suppl 3:835-44
references: 10091154
references: J Clin Endocrinol Metab. 2002 Jun;87(6):2751-9
references: 12050245
references: Acta Paediatr Scand. 1990 Aug-Sep;79(8-9):790-5
references: 2239274
references: Eur J Endocrinol. 1998 Apr;138(4):394-400
references: 9578506
references: N Engl J Med. 2005 Sep 15;353(11):1135-46
references: 16162884
references: Clin Endocrinol (Oxf). 2005 Jun;62(6):667-71
references: 15943827
references: J Clin Endocrinol Metab. 1986 Feb;62(2):263-7
references: 3079770
references: Blood. 2004 Jul 1;104(1):34-9
references: 14988152
references: J Endocrinol Invest. 2002 Apr;25(4):338-44
references: 12030605
references: J Clin Endocrinol Metab. 2005 Jan;90(1):32-8
references: 15483073
references: Eur J Endocrinol. 2005 Aug;153(2):257-64
references: 16061832
references: Pediatr Endocrinol Rev. 2004 Dec;2 Suppl 2:256-8
references: 16462706
references: J Clin Endocrinol Metab. 2002 May;87(5):2067-79
references: 11994342
references: J Clin Endocrinol Metab. 2004 Jul;89(7):3397-401
references: 15240621
references: Clin Endocrinol (Oxf). 1991 Oct;35(4):335-9
references: 1752061
references: J Pediatr Endocrinol Metab. 2001 Sep-Oct;14(8):1133-7
references: 11592571
references: J Clin Endocrinol Metab. 1998 Dec;83(12):4257-62
references: 9851760
references: Clin Endocrinol (Oxf). 1995 Apr;42(4):359-63
references: 7750189
references: N Engl J Med. 1999 Jul 8;341(2):99-109
references: 10395635
references: Ann Hematol. 2003 Oct;82(10):637-40
references: 12898188