Exacerbation of BMI after cessation of growth hormone therapy in patients with Prader-Willi syndrome.
Long-term treatment with growth hormone (GH) in patients with Prader-Willi syndrome (PWS) improves not only height velocity, height standard deviation score, and final height, but also the degree of obesity and body composition abnormalities. Anecdotally, PWS patients tend to suffer from severe obesity and its complications after cessation of GH therapy. However, there have been no studies to investigate changes in body mass index (BMI) and adipose tissue distribution after cessation of GH therapy in young PWS patients. Therefore, we investigated changes in the BMI-standard deviation score (SDS) and adipose tissue distribution after cessation of GH therapy in PWS patients. We evaluated 14 PWS patients. BMI-SDS was calculated at 0, 6, 12, 18, and 24 months before and after cessation of GH treatment. We also evaluated subcutaneous adipose tissue (SAT) (cm(2)) and visceral adipose tissue (VAT) (cm(2)) area in 8 of the 14 study patients with single slice abdominal computed tomography at the level of the umbilicus. The BMI-SDS significantly increased at 6, 12, 18, and 24 months after cessation of GH therapy (P = 0.039, P = 0.008, P = 0.003, P = 0.003, respectively). There was a tendency toward increases in VAT at 12 and 24 months after cessation of GH therapy, but the increases did not reach statistical significance (P = 0.062, P = 0.125, respectively). Therefore, cessation of GH therapy in PWS patients worsened BMI. To maintain good body composition and prevent complications of obesity, long-term use of GH in adult PWS patients may be advisable.
Department of Pediatrics, Dokkyo Medical University, Koshigaya Hospital, Saitama, Japan.
Yuji
Y
Oto
Yuriko
Y
Tanaka
Yoshiko
Y
Abe
Kazuo
K
Obata
Takayoshi
T
Tsuchiya
Atsunori
A
Yoshino
Nobuyuki
N
Murakami
Toshiro
T
Nagai
D050154:Adiposity; D015992:Body Mass Index; D001837:Body Weights and Measures; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology*; D011218:Prader-Willi Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D012189:Retrospective Studies; D013997:Time Factors; D028761:Withholding Treatment
D019382:Human Growth Hormone
BMI; Prader-Willi syndrome; adipose tissue distribution; cessation; growth hormone therapy; subcutaneous adipose tissue; visceral adipose tissue