Idiopathic short stature and growth hormone sensitivity in prepubertal children

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Derraik, Jose G. B.Uppsala universitet,Institutionen för kvinnors och barns hälsa,Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand (author)

Idiopathic short stature and growth hormone sensitivity in prepubertal children

Article/chapterEnglish2019

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2019-04-10
Wiley,2019
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LIBRIS-ID:oai:DiVA.org:uu-388758
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-388758URI
https://doi.org/10.1111/cen.13976DOI

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Language:English
Summary in:English

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Objective: We compared growth hormone sensitivity to an insulin-like growth factor I (IGF-I) generation test in children with idiopathic short stature (ISS) and of normal stature (NS) across the birthweight range.Methods: Forty-six prepubertal children (~7.1 years) born at term were studied: ISS (n = 23; 74% boys) and NS (n = 23; 57% boys). Children underwent a modified IGF-I generation test with recombinant human growth hormone (rhGH; 0.05 mg/kg/d) over four consecutive days. Hormonal concentrations were measured at baseline and day 5.Results: Children with idiopathic short stature were 1.90 SDS lighter (P < 0.0001) but had 4.5% more body fat (P = 0.0007) than NS children. Overall, decreasing birthweight SDS across the normal range (-1.9 to +1.5 SDS) was associated with lower percentage IGF-I response to rhGH stimulation in univariable (r = 0.45; P = 0.002) and multivariable models (β = 24.6; P = 0.006). Plasma IGF-I concentrations rose in both groups with rhGH stimulation (P < 0.0001). GHBP levels (P = 0.002) were suppressed in ISS children (-19%; P = 0.029) but increased among NS children (+18%; P = 0.028), with contrasting responses also observed for leptin and IGFBP-1. Further, the increase in insulin concentrations in response to rhGH stimulation was ~3-fold greater in NS children (142% vs 50%; P = 0.006).Conclusions: A progressive decrease in birthweight SDS was associated with a reduction in GH sensitivity in both NS and ISS children. Thus, the lower IGF-I response to rhGH stimulation in association with decreasing birthweight indicates that the ISS children at the lower end of the birthweight spectrum may have partial GH resistance, which may contribute to their poorer growth.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
growth hormone binding globulin
height
insulin-like growth factor I
recombinant human growth hormone
sensitivity

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Miles, Harriet L.Univ Auckland, Liggins Inst, Auckland, New Zealand (author)
Chiavaroli, ValentinaUniv Auckland, Liggins Inst, Auckland, New Zealand (author)
Hofman, Paul L.Univ Auckland, Liggins Inst, Auckland, New Zealand (author)
Cutfield, Wayne S.Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand (author)
Uppsala universitetInstitutionen för kvinnors och barns hälsa (creator_code:org_t)

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In:Clinical Endocrinology: Wiley91:1, s. 110-1170300-06641365-2265

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