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Low Growth Hormone-Binding Protein in Infants with Congenital Hypothyroidism

Department of Pediatrics, University of Bologna (A.C., E.C., A.B., C.C., A.P., G.P.S., M.L., P.P.); Central Laboratory (R.D.I.); and the Unit of Clinical Pharmacology, St. Orsola Hospital (S.B.), Bologna, Italy

Address all correspondence and requests for reprints to: Prof. Emanuele Cacciari, Clinica Pediatrica I, Via Massarenti 11, 40138 Bologna, Italy. E-mail ped1{at}alma.unibo.it

We evaluated the circulating levels of GH, insulin-like growth factor I (IGF-I), GH-binding protein (GHBP), and IGF-binding protein-3 (IGFBP-3) before L-T₄ therapy in 19 infants with congenital hypothyroidism (CH), aged 12–29 days, diagnosed by neonatal screening and in a group of age- and sex-matched control infants. The same parameters were reevaluated after several months of treatment. Serum GHBP was measured by the high performance liquid chromatography-gel filtration method; serum GH, IGF-I, and IGFBP-3 levels were determined by commercial kits.

The hypothyroid patients, before beginning therapy, presented significantly lower GHBP values than controls (P < 0.0001); during treatment, these values increased significantly; however, after 6 months they were still significantly lower than control values (P < 0.01). The pretreatment levels of GH were not significantly different from control values; after 1 month of treatment, GH did not show the decrease observed in controls and, therefore, was significantly higher (P < 0.01). The pretreatment levels of IGF-I were not significantly different from control values, but were lower in patients with severe than in those with mild hypothyroidism. They decreased at about 4 months of life and became significantly lower than control values at about 7 months of age (P < 0.05).

In conclusion, it may be hypothesized that the condition of CH induces a change in GHBP expression, perhaps beginning in fetal life. The intrauterine production of IGF-I seems to be independent of the levels of GHBP and partially affected by fetal thyroid function.

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				A. Cassio, E. Cacciari, A. Cicognani, G. Damiani, G. Missiroli, E. Corbelli, A. Balsamo, M. Bal, and S. Gualandi Treatment for Congenital Hypothyroidism: Thyroxine Alone or Thyroxine Plus Triiodothyronine? Pediatrics, May 1, 2003; 111(5): 1055 - 1060. [Abstract] [Full Text] [PDF]