Growth hormone treatment, final height, insulin-like growth factors, ghrelin, and adiponectin in four siblings with Seckel syndrome.
OBJECTIVE
To report on the effect of growth hormone (GH) treatment on final height (FH) and to describe the insulin-like growth factor (IGF) system, ghrelin, and adiponectin (ADPN) in children with Seckel syndrome.


RESULTS
Four severely growth-retarded Iraqi siblings (two girls and two boys) with Seckel syndrome were referred at ages 16.5, 14.4, 12.4, and 10.4 years. They were born at term, but their growth was retarded and birth weight ranged between 1 and 1.5 kg. The children were healthy and had a normal response to GH provocative test. Long-term GH treatment of the youngest brother and sister increased the FH by 7.2 and 3.4 cm, respectively, compared with their older brother and sister. At FH, body mass index standard deviation scores (BMISDS) ranged from -3.0 to -3.9. Serum levels of immunoreactive IGF-1, bioactive IGF-1, and IGF-binding protein 3 were all within normal to high range before GH treatment and increased after GH treatment. Fasting plasma ghrelin remained severely reduced. Despite low BMISDS, plasma ADPN was moderately reduced and showed an almost complete absence of the low-molecular-weight subform.


CONCLUSIONS
This is the first report on the effect of GH treatment on FH in children with Seckel syndrome. GH may have increased FH. In addition to growth defects and reduced BMISDS, patients with Seckel syndrome are characterized by low fasting ghrelin levels, low total ADPN, and near deficiency of the low-molecular-weight ADPN subform. The possible significance of the hormonal changes requires further investigations.
Department of Pediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark. nielbirk@rm.dk
Niels H
NH
Birkebaek
Ole D
OD
Wolthers
Carsten
C
Heuch
Thomas
T
Balslev
Allan
A
Flyvbjerg
Jan
J
Frystyk
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D001827:Body Height / Q000187:drug effects; D002648:Child; D004392:Dwarfism / Q000188:drug therapy* / Q000378:metabolism*; D019066:Facies; D005260:Female; D054439:Ghrelin / Q000097:blood; D057238:Growth Charts; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008831:Microcephaly / Q000188:drug therapy* / Q000378:metabolism*; D035781:Siblings; D016896:Treatment Outcome
C499918:ADIPOQ protein, human; D052242:Adiponectin; D054439:Ghrelin; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I