[The effect of one year therapy with recombinant human growth hormone (rhGH) on growth velocity, calcium-phosphorus metabolism, bone mineral density and changes in body composition in children with growth hormone deficiency (GHD)].
BACKGROUND
The most significant effect of growth hormone treatment is growth promotion. For adults the metabolic effect is the most important. This treatment has an influence on the forming of correct composition of body mass, on metabolism of osseous tissue and bone mineral density.


OBJECTIVE
Comparison between the rate of growth and estimation of calcium-phosphorus metabolism, bone mineral density and change of body composition in children with growth hormone deficiency during the first year of growth hormone treatment.


METHODS
The treatment included 120 children and adolescents (85 boys and 35 girls) in age from 6 to 21.5 years old (the average age: 14.2+/-3.0) who were treated in Dept. of Endocrinology and Diabetology for Children and Adolescents during the years 2002-2006 as a result of growth hormone deficiency. Children suffering from panhypopituitarism and other diseases were excluded from the research. The following parameters were included in the analysis: age and sex, age at the start of treatment, the degree of growth hormone deficiency, concentration of calcium, magnesium and phosphates in blood serum, mineral density of bones (BMD), the concentration of osseous minerals, concentration of adipose tissue and lean body mass. All the children were treated with recombined human growth hormone (rhGH) in dose of 0.7 j/kg per week. No interruption of the treatment was noticed.


RESULTS
Partial growth hormone deficiency (GHD) was diagnosed in the group of 71 children (52 boys and 19 girls), total GHD diagnosed in 49 cases (34 boys and 15 girls). Average age at the start of treatment was 11.7+/-2.9 years. During the first year of treatment the rate of growing increases from 3.9+/-1,1 cm per year before treatment to 8.72+/-2.27 cm per year (p<0.01) for the whole examined group, for girls from 3.8+/-1.2 cm per year to 8.77 cm per year (p<0.01), for boys from 3.2+/-1.3 per year to 8.58+/-2.20 cm per year (p<0.01). Average concentrations of calcium, magnesium and alkaline phosphatase (ALP) in blood serum remain in accordance with laboratory standards and were statistically not significant. In the majority of patients LBM increased significantly from 28 689+/-4423 g to 35 549.09+/-2968 g (p<0,05) and FM decreased from 21 070+/-4019,8 g (33,15+/-7,6%) to 19 075.37+/-4307,3 g (26.15+/-8.6%) (p<0.05). The alternations of the body composition in GH deficient children treated with rhGH occurred during the first year of therapy.
Katedra i Klinika Endokrynologii i Diabetologii Wsieku Rozwojowego Akademii Medycznej, Wroclaw. teresa.zak@post.pl
Teresa
T
Zak
Aleksander
A
Basiak
Agnieszka
A
Zubkiewicz-Kucharska
Anna
A
Noczyńska
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density; D002118:Calcium / Q000097:blood; D002648:Child; D005260:Female; D006128:Growth / Q000187:drug effects*; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010758:Phosphorus / Q000097:blood; D011994:Recombinant Proteins; D055815:Young Adult
D011994:Recombinant Proteins; D019382:Human Growth Hormone; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002118:Calcium