Hyperbolic function shows close correlation between growth hormone (GH) sensitivity and GH secretion

• Background Impressive similarities exist between the insulin resistance-associated metabolic syndrome and untreated growth hormone (GH) deficiency in both children and adults. Central findings are visceral obesity and cardiovascular morbidity. Children with lower GH sensitivity but normal GH secretion like in idiopathic short stature (ISS) belong to a continuous spectrum of imbalanced GH secretion in relation to GH sensitivity. Hypothesis The relationship between secretion and sensitivity is similar for GH and insulin. Materials & methods 153 short prepubertal children with a broad range of secretion and sensitivity were included. From the 24-hour GH profile (72 x 20 min), the 24h GH secretion rate was estimated with a deconvolution method. The secretion rates above the basal level was calculated by PULSAR (GHb). The prediction model estimated the growth response, predicted delta height SDS, a measure of GH sensitivity/ responsiveness. Discussion GH treatment is neither individualized like insulin treatment with adaption to individual sensitivity nor applied in children with ISS. In order to fill gaps in knowledge, we have previously shown that individualized GH treatment is beneficial in reducing the range of growth response and metabolic responses in both GHD and ISS prepubertal children(2, 5, 6). Thus, despite administering higher doses to children being less sensitive to GH, individualized GH treatment is safe in metabolic terms. As insulin dosing is individualized in type-2 diabetes mellitus, it can be recommended to individualize GH dosing in ISS children. The metabolic impact of untreated versus treated ISS in the long term is an issue of further studies. Conclusion Our data confirms similarities between insulin and GH regarding the hyperbolic function between secretion and sensitivity.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

Growth hormone

sensitivity

secretion

24-hour profile

hyperbolic function

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