title: Insufficient growth hormone secretion is associated with metabolic syndrome after allogeneic stem cell transplantation in childhood.
abstract: The aim was to evaluate whether the metabolic syndrome associates with other endocrinopathies observed after allogeneic stem cell transplantation (SCT) in childhood. Thirty-one SCT long-term survivors, transplanted for leukemia (n=26) or nonmalignant hematologic diseases (n=5) were evaluated by oral glucose tolerance test and assessment of serum lipids at a median age of 15 (range 7 to 34) years. Hyperinsulinemia, hypertriglyceridemia, and abdominal obesity were required for the diagnosis of metabolic syndrome. Growth hormone (GH) secretion was evaluated either with GH releasing hormone and arginine (n=14), clonidine (n=15), or insulin-tolerance (n=2) test. A GH peak level of <20 mU/L was considered insufficient. The thyroid and gonadal functions were assessed. Twelve patients (39%) had metabolic syndrome. Nine out of 12 (75%) patients with metabolic syndrome had insufficient GH response in provocative testing as opposed to 6/19 (31%) of those without it (P=0.02). No difference was observed in thyroid or gonadal function between patients with versus without metabolic syndrome. In conclusion, metabolic syndrome is frequently associated with insufficient GH secretion in the SCT long-term survivors. This should implicate a close follow-up of the metabolic parameters in SCT patients with either frank GH insufficiency or signs of inadequate GH response in provocative testing.
authors.affiliation: Hospital for Children and Adolescents, University of Helsinki, Helsinkil, Finland. mervi.taskinen@hus.fi
authors.forename: Mervi
authors.initials: M
authors.lastname: Taskinen
authors.forename: Marita
authors.initials: M
authors.lastname: Lipsanen-Nyman
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.forename: Liisa
authors.initials: L
authors.lastname: Hovi
authors.forename: Ulla M
authors.initials: UM
authors.lastname: Saarinen-Pihkala
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005951:Glucose Tolerance Test; D006066:Gonads / Q000503:physiopathology; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency* / Q000378:metabolism; D006801:Humans; D007938:Leukemia / Q000601:surgery; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000209:etiology*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D013961:Thyroid Gland / Q000503:physiopathology; D014184:Transplantation, Homologous
chemical_list: D008055:Lipids; D013006:Growth Hormone