Short-term effects of growth hormone treatment on the upper airways of non severely obese children with Prader-Willi syndrome.
OBJECTIVE
The aim of this study was to establish whether short-term GH treatment causes obstructive apnea in patients with Prader-Willi syndrome and normal upper airway patency.


METHODS
We performed an observational longitudinal 6-week GH treatment study. Thirty-four non-severely obese Prader-Willi syndrome patients (20 boys, age range 0.94-11.8 yr, median 2.24 yr) entered an observational longitudinal 6-week study. Sixteen boys received recombinant human GH (rhGH) treatment; the remaining 18 represented the control group and received no treatment. Polysomnography monitoring and othorhinolaringoiatric video endoscopy were performed one night before and after 6 weeks of rhGH treatment (0.03 mg/kg body weight/day). All patients underwent auxologic assessment, fasting blood glucose, insulin and IGF-I evaluation. The main polysomnographic parameter considered was total apnea hypopnea index, consisting of two components: central apnea hypopnea index and obstructive apnea hypopnea index. All patients were free of severe or moderate upper airway obstruction when rhGH treatment began.


RESULTS
After 6 weeks of rhGH therapy, obstructive apnea hypopnea index increased in 8/16 (50%), decreased in 5/16 (31%), and did not change in 3/16 (19%) patients. The changes were not statistically significant. The rhGH-treated group did not differ from the control group for the apnea hypopnea index both before and after 6 weeks of treatment. Adenoids and tonsils showed a slight increase in 1 and 2 patients on rhGH treatment, respectively, and did not change in the untreated patients.


CONCLUSIONS
Our data show that short-term rhGH treatment does not cause restrictions of the upper airways in patients with Prader-Willi syndrome and normal upper airway patency.
Salvatoni
A
A
Pediatric Clinic, Insubria University, Varese, Italy. alessandro.salvatoni@uninsubria.it
Veronelli
E
E
Nosetti
L
L
Berini
J
J
de Simone
S
S
Iughetti
L
L
Bosio
L
L
Chiumello
G
G
Grugni
G
G
Delù
G
G
Castelnuovo
P
P
Trifirò
G
G
Nespoli
L
L
D000886:Anthropometry; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D009765:Obesity / Q000150:complications*; D017286:Polysomnography; D011218:Prader-Willi Syndrome / Q000188:drug therapy / Q000503:physiopathology; D011994:Recombinant Proteins / Q000627:therapeutic use*; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014132:Trachea / Q000187:drug effects* / Q000473:pathology
D001786:Blood Glucose; D007328:Insulin; D011994:Recombinant Proteins; D019382:Human Growth Hormone