Metabolic changes across tertiles of delta changes in height-SDS during growth hormone therapy in children with Growth Hormone Deficiency (GHD) Introduction: Obesity, dyslipidemia, hypertension, insulin resistance, are components of the Metabolic Syndrome and in adults are positively affected by growth hormone (GH) treatment. Few data are available in youth especially evaluating the improvement of metabolic features after start GH treatment. The aim of this study was to evaluate changes in metabolic profile in GHD children across tertiles of h-SDS changes after at least 20 months of GH therapy. Methods: Data from 51 normal weight children and adolescents with GHD (age: 11.4±2.3 years; h-SDS: -2.25±-1.94) who had performed a complete metabolic profile including IGF-1, lipid profile (total cholesterol [TC], triglycerides [TG], HDL-cholesterol), glucose metabolism (fasting glycemia, insulin, Hemoglobin A1c [HbA1c] levels), and insulin resistance indices (HOMA, TG/HDL ratio) before and after start GH treatment were analysed. Subjects who had received GH therapy for at least 20 months were eligible. Delta changes were calculated for each variable. Subjects were divided according to tertiles of delta-changes of h-SDS (1st tertile; 2nd tertile; 3rd tertile) before and after a period of GH treatment. Results: In each tertile group a significant increase of height-SDS was documented. Delta changes of glucose metabolism, lipid profile and insulin resistance indices significantly improved across tertiles groups, showing the highest tertile a better metabolic pattern. Discussion/Conclusions: GH therapy is associated with improvement of metabolic profile. Delta changes seem to be more evident in those children with a higher tertile of delta h-SDS after start GH therapy. A tailored therapy aimed to reach a proper goal in h-SDS after GH treatment might be necessary in order to reduce cardiovascular risk in GHD children.


中文翻译：

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生长激素缺乏症 (GHD) 儿童生长激素治疗期间身高 SDS 三角洲变化的代谢变化

生长激素缺乏症 (GHD) 儿童生长激素治疗期间身高 SDS 三角洲变化的代谢变化(GH) 治疗。青年人的数据很少，特别是评估开始 GH 治疗后代谢特征的改善情况。本研究的目的是评估 GHD 儿童在接受至少 20 个月的 GH 治疗后，在 h-SDS 变化的三分位范围内的代谢特征变化。方法：数据来自 51 名体重正常的 GHD 儿童和青少年（年龄：11.4±2.3 岁；h-SDS：-2.25±-1.94），他们进行了完整的代谢分析，包括 IGF-1、脂质分析（总胆固醇 [TC] , 甘油三酯 [TG], HDL-胆固醇), 分析了开始 GH 治疗前后的葡萄糖代谢（空腹血糖、胰岛素、血红蛋白 A1c [HbA1c] 水平）和胰岛素抵抗指标（HOMA、TG/HDL 比率）。接受 GH 治疗至少 20 个月的受试者符合条件。计算每个变量的增量变化。根据 GH 治疗前后的 h-SDS 增量变化的三分位数（第一三分位数；第二三分位数；第三三分位数）对受试者进行分组。结果：在每个三分位数组中，记录了身高-SDS 的显着增加。葡萄糖代谢、脂质谱和胰岛素抵抗指数的增量变化在三分位数组中显着改善，显示最高三分位数更好的代谢模式。讨论/结论：GH 治疗与代谢特征的改善有关。在开始 GH 治疗后具有更高三分位数 delta h-SDS 的儿童中，Delta 变化似乎更为明显。为了降低 GHD 儿童的心血管风险，可能需要一种旨在在 GH 治疗后达到 h-SDS 适当目标的量身定制的治疗。