Revaluation of the clinical and metabolic behavior of children with isolated growth hormone deficiency during GH treatment according to newly proposed note 39 of the Italian Medicines Agency (AIFA)

Ciresi, Alessandro; Cicciò, F.; Amato, Marco; Giordano, Carla

doi:10.1007/s40618-015-0314-7

Cited by 16 publications

(18 citation statements)

References 32 publications

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“…Indeed, it is widely known that GHT leads to a decrease in insulin sensitivity and alteration in insulin secretion even without overt changes in glucose tolerance, and the current study confirms this finding, as demonstrated by the unchanged HbA1c levels. In addition, a slight improvement in lipid profile was demonstrated after 12 months of GHT and this finding is in agreement with our previous studies [15,40]. Overall, in our opinion, the metabolic changes which occur after GHT are likely secondary to the counter-regulating effects of GH (the increase in glucose and insulin levels and the reduction in insulin sensitivity) and to its lipolytic effect (demonstrated by the improvement in lipid profile and reduction in WC).…”

Section: Discussionsupporting

confidence: 92%

“…As radiological criteria we considered a bone age delay, estimated from an X-ray of the left wrist and hand and evaluated according to the methods of Greulich and Pyle, of at least 1 year with respect to the chronological age [14]. Biochemically, GHD was diagnosed by the failure of GH to respond to glucagon stimulation test (GST) and insulin tolerance test (ITT), with GH peaks below 8 µg/l [15]. Neuroimaging, with magnetic resonance of the hypothalamic-pituitary region, was performed in all children with more severe GHD, i.e., with GH peak ≤3 μg/l, and when we suspected there was a multiple pituitary deficiency (overall in 11 children).…”

Section: Methodsmentioning

confidence: 99%

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Correlation between adrenal function, growth hormone secretion, and insulin sensitivity in children with idiopathic growth hormone deficiency

Ciresi

Radellini

Vigneri

et al. 2017

J Endocrinol Invest

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Correlation between adrenal function, growth hormone secretion, and insulin sensitivity in children with idiopathic growth hormone deficiency

Ciresi

Radellini

Vigneri

et al. 2017

J Endocrinol Invest

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“…Indeed, given the insulin antagonistic action of GH in addition to the direct stimulatory effect on β -cell, GHT can lead to glucose metabolism impairment through a decrease in insulin sensitivity and an impairment of pancreatic β -cell function [35]. We previously demonstrated an increase in Homa-IR, related to the increased insulin levels, in GHD children after GHT [36, 37], and a degree of impairment of glucose metabolism during GHT has often been previously demonstrated [38]. However, the limit of the evaluation of the insulin sensitivity and secretion performed through insulin-derived indexes [39] is always to be taken into account.…”

Section: Discussionmentioning

confidence: 99%

More Favorable Metabolic Impact of Three-Times-Weekly versus Daily Growth Hormone Treatment in Naïve GH-Deficient Children

Ciresi

Cicciò

Radellini

et al. 2017

International Journal of Endocrinology

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Objective To evaluate whether two different regimens of weekly injections could lead to similar auxological and metabolic effects in children with growth hormone deficiency (GHD). Design 32 GHD children (25 males, mean age 10.5 ± 2.2 yr) were randomly assigned to receive daily (group A, 16 patients) or TIW (group B, 16 patients) GHT for 12 months. Methods Auxological parameters, insulin-like growth factor-I (IGF-I), glucose and insulin during OGTT, glycosylated hemoglobin (HbA1c), lipid profile, the oral disposition index (DIo), the homeostasis model assessment estimate of insulin resistance (Homa-IR), and the insulin sensitivity index (ISI). Results After 12 months, both groups showed a significant and comparable improvement in height (p < 0.001) and IGF-I (p < 0.001). As regards the metabolic parameters, in both groups, we found a significant increase in fasting insulin (p < 0.001 and p = 0.026) and Homa-IR (p < 0.001 and p = 0.019). A significant increase in fasting glucose (p = 0.001) and a decrease in ISI (p < 0.001) and DIo (p = 0.002) were only found in group A. Conclusions The TIW regimen is effective and comparable with the daily regimen in improving auxological parameters and has a more favorable metabolic impact in GHD children. This trial is registered with ClinicalTrials.gov NCT03033121.

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“…Several studies have demonstrated that GH, apart from promoting lineal growth, plays a key role in various metabolic processes .…”

Section: Discussionmentioning

confidence: 99%

“…Growth hormone replacement therapy in GHD children benefits lipid metabolism, and many studies have noted that it decreases total cholesterol, LDL cholesterol and triglycerides and causes a moderate increase in HDL cholesterol after at least one year of replacement therapy . However, other authors have not reported any effect on children’s lipid metabolisms .…”

Section: Introductionmentioning

confidence: 99%

Effects of growth hormone therapy on metabolic parameters, adipokine and endothelial dysfunction in prepuberal children

et al. 2019

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Aim: To determine whether non-obese prepubertal children with growth hormone deficiency (GHD) present changes in lipid metabolism, and adipokines, and to assess the short-term effects of growth hormone (GH) treatment on these parameters.Methods: Prospective observational follow-up and case-control (36 GHD children and 38 healthy children) study lasted for six months. Means of values from groups were compared, control group versus GHD baseline group, and GHD baseline group versus GHD after six months of GH replacement therapy. Lipid profile, glucose, insulin, homeostatic model assessmentinsulin resistance (HOMA-IR), leptin, adiponectin and soluble intercellular adhesion molecule-1 (sICAM-1) were all analysed.Results: Growth hormone deficiency children show higher baseline levels of total cholesterol, LDL cholesterol, triglycerides, Apo B and sICAM-1, but lower levels of free fatty acids, insulin and HOMA-IR. After six months of treatment, cholesterol, LDL cholesterol, Apo B, T cholesterol/HDL cholesterol, insulin, HOMA-IR and leptin levels decreased. The changes in insulin and HOMA-IR levels correlated inversely with the changes in HDL cholesterol and Apo A1 levels. A correlation was also observed between the changes in adiponectin levels and the changes in HDL cholesterol and Apo A1 levels. Variations in leptin levels were correlated with changes in triglycerides. Conclusion:Prepubertal non-obese GHD children present altered lipid profiles and adipokine levels. Replacement therapy with GH improves these variables.

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Revaluation of the clinical and metabolic behavior of children with isolated growth hormone deficiency during GH treatment according to newly proposed note 39 of the Italian Medicines Agency (AIFA)

Cited by 16 publications

References 32 publications

Correlation between adrenal function, growth hormone secretion, and insulin sensitivity in children with idiopathic growth hormone deficiency

Correlation between adrenal function, growth hormone secretion, and insulin sensitivity in children with idiopathic growth hormone deficiency

More Favorable Metabolic Impact of Three-Times-Weekly versus Daily Growth Hormone Treatment in Naïve GH-Deficient Children

Effects of growth hormone therapy on metabolic parameters, adipokine and endothelial dysfunction in prepuberal children

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