title: A preliminary trial of the effect of recombinant human growth hormone on short-term linear growth and glucose homeostasis in children with Crohn's disease.
abstract: BACKGROUND
  It is unclear whether recombinant human growth hormone (rhGH) improves linear growth in children with Crohn's disease (CD).
  
  
  OBJECTIVE
  To investigate the effects of rhGH on height velocity (HV) and glucose homeostasis over a 6-month period.
  
  
  METHODS
  Randomized controlled trial in two tertiary children's hospitals in 22 children with inflammatory bowel disease amongst whom 21 had CD. Duration of disease from diagnosis and number of acute relapses requiring either exclusive enteral nutrition or therapeutic dose of oral prednisolone were similar in the treatment and control groups.
  
  
  METHODS
  Either rhGH (0·067 mg/kg per day) as daily subcutaneous injections (rhGH group; n, 11) or no rhGH, (Ctrl; n, 11) for 6 months.
  
  
  METHODS
  Percentage change in HV after 6 months in the two groups. Auxology, puberty, skeletal age, disease factors, treatment and glucose homeostasis were also assessed.
  
  
  RESULTS
  Median HV increased from 4·5 (range, 0·6, 8·9) at baseline to 10·8 (6·1, 15·0) cm/year at 6 month (P = 0·003) in the rhGH group, whereas in the Ctrl group, it was 3·8 (1·4, 6·7) and 3·5 cm/year (2·0, 9·6), respectively (P = 0·58). Median percentage increase in HV after 6 months in the rhGH group was 140% (16·7, 916·7) compared with 17·4% (-42·1%, 97·7%) in the Ctrl group (P < 0·001). There were no significant differences in disease activity and proinflammatory cytokines at baseline and 6 months in both groups and change in bone age for chronological age was also similar in the two groups. In the rhGH group, fasting insulin increased from 4·0 (2·0, 11·0) to 7·0 mU/l (2·0, 16·0) (P = 0·02), whereas in the Ctrl group, it was 3·0 (1·2, 12·7) and 3·8 mU/l (2·1, 7·0) (P = 0·72), respectively.
  
  
  CONCLUSIONS
  Although this pilot trial shows that rhGH can improve short-term linear growth in children with CD, the clinical efficacy of this therapy needs to be further studied in longer-term studies of growth, glucose homeostasis and disease status.
authors.affiliation: Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Wong
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: P J
authors.initials: PJ
authors.lastname: Galloway
authors.forename: J C
authors.initials: JC
authors.lastname: Blair
authors.forename: M
authors.initials: M
authors.lastname: Didi
authors.forename: A M
authors.initials: AM
authors.lastname: Dalzell
authors.forename: K
authors.initials: K
authors.lastname: Hassan
authors.forename: P
authors.initials: P
authors.lastname: McGrogan
authors.forename: S Faisal
authors.initials: SF
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004750:Enteral Nutrition; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006706:Homeostasis / Q000187:drug effects*; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D007328:Insulin; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D011239:Prednisolone; D005947:Glucose