Discontinuation of growth hormone (GH) treatment: metabolic effects in GH-deficient and GH-sufficient adolescent patients compared with control subjects. Swedish Study Group for Growth Hormone Treatment in Children.

• The need for continuing GH replacement in patients with childhood-onset GH deficiency continuing into adulthood has been recognized. The metabolic consequences of discontinuing GH in adolescent patients with childhood-onset GH deficiency and short stature were examined over a period of 2 yr. Forty adolescents (aged 16-21 yr) receiving GH treatment for more than 3 yr and 16 closely matched healthy controls were studied. After a baseline visit, GH treatment was discontinued. The patients were then examined with the same protocol once a year for 2 yr. Twenty-one patients had severe GH deficiency (GHD) into adulthood, whereas 19 patients were regarded as having sufficient endogenous GH secretion (GHS). After 2 yr without GH treatment, the serum insulin-like growth factor I level was lower in GHD than in both GHS and control subjects. Both before and 2 yr after GH treatment was discontinued, serum concentrations of total cholesterol (C), low density lipoprotein C, and apolipoprotein B were higher in the GHD than in both GHS and control subjects. Serum concentrations of high density lipoprotein C decreased in the GHD group and increased in the other 2 study groups. The amount of total body and abdominal fat mass throughout the study and the increment in these masses were more marked in the GHD than in the GHS and control subjects when GH treatment was discontinued. The discontinuation of GH therapy in adolescents with severe GHD continuing into adulthood results over a period of 2 yr in the accumulation of important cardiovascular risk factors that are associated with GHD in adults.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

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

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

Keyword

Adolescent

Adult

Apolipoproteins B

blood

Blood Glucose

metabolism

Blood Pressure

Body Composition

Cardiovascular Diseases

blood

Cholesterol

blood

Cholesterol

HDL

blood

Cholesterol

LDL

blood

Female

Human Growth Hormone

deficiency

therapeutic use

Humans

Insulin-Like Growth Factor Binding Protein 3

blood

Insulin-Like Growth Factor I

metabolism

Lipids

blood

Male

Prospective Studies

Risk Factors

Publication and Content Type

ref (subject category)

art (subject category)