Impact of BMI on peak growth hormone responses to provocative tests and therapeutic outcome in children with growth hormone deficiency

Abstract

This study investigated the relationship between peak stimulated growth hormone (GH) and body mass index (BMI), as well as the impact of BMI on therapeutic response in patients with GH deficiency (GHD). A total of 460 patients were enrolled in the study. The patients were divided into four groups as per the etiology and peak GH values: idiopathic (n = 439), organic (n = 21), complete (n = 114), and partial (n = 325) GHD groups. Subsequently, they were classified as normal, overweight, or obese based on their BMI. There was no difference in BMI between complete and partial GHD. A significant negative relationship between peak GH and BMI were found. Moreover, obese GHD children had a considerably better therapeutic response in height increase and BMI decrease during 2 years of GH treatment compared to non-obese children with GHD. There was no difference between peak GH and type of GH stimulation test (GHST), except the clonidine test, which showed a much lower peak GH in obese GHD children. In conclusion, BMI had a negative impact on peak GH response, and therapeutic outcome was more favorable in the obese group. Despite no difference in GH response by type of GHST, the degree of obesity differentially affected the results.

Dexamethasone Stimulation Test in the Diagnostic Work-Up of Growth Hormone Deficiency in Childhood: Clinical Value and Comparison With Insulin-Induced Hypoglycemia

“…Indeed, height SDS was statistically lower in females (mean height SDS: -2.65 ± 0.85) than males (-2.32 ± 0.94, p value of 0.02). Finally, the demonstrated negative correlation between BMI-SDS and GH peaks has been already widely described (31). In our study population, GH ITT and GH DST cohorts were statistically homogeneous in terms of baseline BMI-SDS levels and did not differ with reference to the negative effect of BMI on the GH peaks elicited by both ITT and DST, with a 5% and 6% drop in GH peaks for 1 BMI-SDS increase, respectively.…”

Association between triglyceride glucose index and peak growth hormone in children with short stature

“…It is well known that the secretion of GH is significantly reduced in obese individuals compared to age-matched controls 40 . Given the clear relationship between BMI and peak stimulated GH demonstrated in short stature, our findings are consistent with previous studies 6 , 7 . We found a negative association between BMI and peak GH in children with short stature.…”

“…However, GH secretion is regulated by multiple physiologic factors, including age, sex, body mass index (BMI) and onset of puberty, which sometimes may produce false-positive results 2 – 4 . Previous studies have demonstrated that obese children and adolescents have a reduced stimulated GH response to provocative testing 5 , and it is well known that there is a significant negative association between BMI and peak GH 6 , 7 . Furthermore, insulin resistance (IR) has been demonstrated to be involved in the relationship between BMI and reduced growth hormone secretion 8 .…”

Effect of body mass index on peak growth hormone level after growth hormone stimulation test in children with short stature

“…Several studies have reported that the relationship between BMI SDS and peak GH in children. [16][17][18][19][20] Although each study used different number of subjects, different period of study or different number of stimulant used for analysis, they all demonstrated the relationship between BMI SDS and peak serum GH in common.…”