title: Growth retardation and reduced growth hormone secretion in cystic fibrosis. Clinical observations from three CF centers.
abstract: OBJECTIVE
  Growth delay in cystic fibrosis is frequent and is usually the result of several interacting causes. It most often derives from severe respiratory impairment and severe malabsorption. There are however patients whose clinical condition is not severe enough to be held accountable for this phenomenon. We aimed at describing patients who showed growth delay, who were not affected by severe pulmonary disease or malabsorption and who, when tested, showed a reduced GH secretion after stimulation with conventional agents. We noticed a disproportionately large prevalence of growth hormone (GH) release deficit (GHRD) in pediatric cystic fibrosis (CF) patients.
  
  
  METHODS
  We examined all patients under our care in the period 2006-11, who were older than 5 and younger than 16 years old. We focussed on those who fell below the 3rd height percentile, or whose growth during the previous 18 months faltered by >2SD, and who did not present clinical conditions that could reasonably explain their failure to thrive. These patients were subjected to standard GH provocative tests.
  
  
  RESULTS
  Out of 285 who matched the age criterion, 33 patients also matched the height percentile criterion. While 15/33 suffered clinical conditions that could reasonably explain their failure to thrive, 18/33 underwent GH release provocative tests and 12/18 showed a release deficit.
  
  
  CONCLUSIONS
  We conclude that impaired GH secretion is more frequent among CF patients compared to the prevalence of GH deficiency in the general population and that GH release impairment may be an independent cause of growth delay in CF. Our findings are in agreement with recent studies that have described low GH levels in CF piglets and in neonates with CF [1].
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: D'Orazio
authors.initials: D
authors.lastname: Ciro
authors.affiliation: Centro Regionale di Supporto per la Fibrosi Cistica, Ospedale dei Bambini, AO Spedali Civili, Brescia, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Padoan
authors.affiliation: Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah-Tikva, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Marostica
authors.affiliation: Centro Regionale di Supporto per la Fibrosi Cistica, Ospedale dei Bambini, AO Spedali Civili, Brescia, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fuoti
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Volpi
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Pilotta
authors.affiliation: Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Meyerovitch
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sher
authors.affiliation: CFC Azienda Ospedaliera Universitaria Integrata di Verona, Italy. Electronic address: baroukh.assael@ospedaleuniverona.it.
authors.forename: Baroukh M
authors.initials: BM
authors.lastname: Assael
mesh_terms: D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007557:Israel; D007558:Italy; D008297:Male
chemical_list: D019382:Human Growth Hormone