Longitudinal anthropometric measurements in patients with growth hormone deficiency. Effect of human growth hormone treatment

Abstract

The effect of human growth hormone (6IU/m2 twice weekly i.m.) on standing, sitting, and subischial leg height, on arm length, head circumference, fronto-occipital and biparietal head diameter, bi-iliac (pelvis) and bihumeral (shoulder) width, body weight, triceps and subscapular skinfold thickness, and upper arm and calf circumferences was studied longitudinally over a period of 2 years in 37 prepubertal growth hormone deficient patients (29 boys, 8 girls). Thirteen of them had isolated growth hormone deficiency, 18 combined defects with other anterior pituitary hormone deficiencies, and 6 had been operated for a craniopharyngioma. The most retarded height and length measurements were influenced most markedly by treatment in the fashion of a characteristic catch-up growth, while head circumference, which was less retarded initially, increased more slowly. With exception of craniopharyngioma patients, who became slightly eunuchoid, both proportions (sitting height versus subischial leg height) were not changed by treatment. The disproportions of shoulder and hip width (relatively wide pelvis, narrow shoulders before treatment) tended to be normalized. The results in patients with operated craniopharyngioma were not as good as in those with idiopathic growth hormone deficiency.

Body Mass Index in Growth Hormone Deficient Children before and during Growth Hormone Treatment

“…The BMI decreases especially in the first 6 months and after 12 months it increases again, but not completely to the initial value. This pattern of initial decrease followed by an increase parallels previous findings of change in skinfold thicknesses during GH therapy in GHD children [7, 8, 9]. It was shown that the decrease in skinfold thickness shows a nadir after 9 months of GH therapy [8].…”

“…Because GHD is associated with a truncal pattern of fat distribution and with increased skinfold thicknesses [7, 8, 9], mild to moderate overweight is usually thought to be a feature of GHD. However, our study shows that GHD children are on the average not heavier than normal children if BMI is used as a parameter of overweight.…”

“…However, little is known about factors that determine the degree of overweight and body weight in general in patients with GHD. Studies have been done on fat and muscle mass in GHD [4, 5, 6, 7, 8, 9, 10], but studies on total body weight and the changes during treatment are rare [10, 11]. These anthropometric investigations have focused on weight for height or age of GHD children, but none of these are reliable parameters for the degree of overweight [12, 13, 14].…”

Growth Hormone Normalises Height, Prediction of Final Height and Hand Length in Children with Prader-Willi Syndrome after 4 Years of Therapy

“…In this group, as well as in other studies in young children with GHD [33, 34, 35], the GH effect was more appropriately reflected by height gain, which, in our study, was equivalent to that of the prepubertal overweight group, and continued to increase during the 4th year of GH treatment. As the increase in hand and foot length was similar to the height increase in all groups, the prepubertal children over 3 years of age no longer had small hands and feet and all body proportion parameters were balanced, as known in GHD patients during therapy [36]. …”

Is There Growth Hormone Deficiency in Prader-Willi Syndrome?

“…Because of a similar increase in hand and foot length and height, these children no longer have small hands and feet and all body proportion parameters are balanced (fig. 1) [69], as happens in treated GHD patients [76]. …”