title: Impact of overweight on effectiveness of treatment with human growth hormone in growth hormone deficient children: analysis of German KIGS data.
abstract: BACKGROUND
  We hypothesized that overweight children with growth hormone deficiency (GHD) demonstrate a lower response to growth hormone (GH) as a result of a misclassification since obesity is associated with lower GH peaks in stimulation tests.
  
  
  METHODS
  Anthropometric data, response, and responsiveness to GH in the first year of treatment were compared in 1.712 prepubertal children with GHD from the German KIGS database according to BMI (underweight=group A, normal weight=group B, overweight=group C) (median age: group A, B, C: 7.3, 7.28, and 8.4 years).
  
  
  RESULTS
  Maximum GH levels to tests (median: group A, B, C: 5.8, 5.8, and 4.0 µg/ml) were significantly lower in group C. IGF-I SDS levels were not different between the groups. Growth velocity in the first year of GH treatment was significantly lower in the underweight cohort (median: group A, B, C: 8.2, 8.8, and 9.0 cm/yr), while the gain in height was not different between groups. The difference between observed and predicted growth velocity expressed as Studentized residuals was not significantly different between groups. Separating the 164 overweight children into obese children (BMI>97th centile; n=71) and moderate overweight children (BMI>90th to 97th centile, n=93) demonstrated no significant difference in any parameter.
  
  
  CONCLUSIONS
  Overweight prepubertal children with idiopathic GHD demonstrated similar levels of responsiveness to GH treatment compared to normal weight children. Furthermore, the IGF-I levels were low in overweight children. Therefore, a misclassification of GHD in overweight prepubertal children within the KIGS database seems unlikely. The first year growth prediction models can be applied to overweight and obese GHD children.
authors: Vestische Hospital for Children and Adolescents, Datteln, University of Witten/Herdecke, Germany. T.Reinehr@kinderklinik-datteln.de
authors: T
authors: T
authors: Reinehr
authors: S
authors: S
authors: Bechtold-Dalla Pozza
authors: M
authors: M
authors: Bettendorf
authors: H-G
authors: HG
authors: Doerr
authors: B
authors: B
authors: Gohlke
authors: B P
authors: BP
authors: Hauffa
authors: S
authors: S
authors: Kaspers
authors: C
authors: C
authors: Land
authors: O
authors: O
authors: Mehls
authors: K-O
authors: KO
authors: Schwab
authors: N
authors: N
authors: Stahnke
authors: M B
authors: MB
authors: Ranke
mesh_terms: D000367:Age Factors; D001827:Body Height / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D005260:Female; D005858:Germany; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008954:Models, Biological; D009765:Obesity / Q000097:blood / Q000150:complications; D050177:Overweight / Q000097:blood / Q000150:complications*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D013851:Thinness / Q000097:blood / Q000150:complications
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I