This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Attanasio, A. F. Articles by Shalet, S. M. Search for Related Content PubMed PubMed Citation Articles by Attanasio, A. F. Articles by Shalet, S. M.

Body Composition, IGF-I and IGFBP-3 Concentrations as Outcome Measures in Severely GH-Deficient (GHD) Patients after Childhood GH Treatment: A Comparison with Adult Onset GHD Patients

Eli Lilly \|[amp ]\| Co. (A.F.A.), Florence 50019, Italy; Christie Hospital (S.H., S.M.S.), Manchester M20 4BX, United Kingdom; Lilly Research Centre (P.C.B., P.F.), Windlesham, Surrey GU20 6PH, United Kingdom; Eli Lilly \|[amp ]\| Co. (J.C.), Indianapolis, Indiana 46285; and Eli Lilly \|[amp ]\| Co. (W.F.B.), 61350 Bad Homburg, Germany

Address all correspondence and requests for reprints to: Dr. Stephen M. Shalet, Department of Endocrinology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. E-mail: . Stephen.M.Shalet{at}man.ac.uk

Abstract

If GH therapy of children with GH deficiency (GHD) has been adequate, body composition should be comparable to that of patients who have undergone normal childhood development and become hypopituitary thereafter. To assess this, body composition was determined in 92 patients with childhood onset (CO) GHD, aged 18–30 yr, who had been treated to final height with GH for 8.98 ± 4.30 yr and had stopped treatment 1.57 ± 1.20 yr previously, but who remained GHD (assessed by a GH stimulation test and IGF-I values). These were compared with 35 age-matched GH-naïve hypopituitary patients with adult onset (AO) GHD. Lean body mass, fat mass, and total bone mineral content were assessed by dual energy x-ray absorptiometry and corrected for actual height. CO patients were shorter (CO height, -1.18 ± 1.16 SD score; AO height, -0.38 ± 1.12 SD score; P < 0.001) and had lower body mass index (CO, 23.19 ± 5.76 kg/m²; AO, 28.9 ± 6.27 kg/m²; P < 0.001) than the AO group. Although there were gender differences, within genders CO patients had lower lean body mass, fat mass, and bone mineral content (P < 0.001 in all cases) compared with AO patients. Standard deviation scores for IGF-I (CO female, -9.2 ± 3.1; AO female, -5.2 ± 2.6; CO male, -6.4 ± 2.7; AO male, -3.5 ± 2.3; P < 0.001 within each gender) and IGFBP-3 (CO female, -3.5 ± 2.5; AO female, -1.7 ± 1.5; CO male, -2.8 ± 2.0; AO male, -1.1 ± 1.6; P < 0.001 within each gender) were significantly lower in the CO group. These results suggest that patients with CO GHD who were treated to final height suffer a significant maturational deficit despite GH replacement during childhood.

This article has been cited by other articles:

				S. Radovick and S. DiVall Approach to the Growth Hormone-Deficient Child during Transition to Adulthood J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1195 - 1200. [Abstract] [Full Text] [PDF]

				L. J. Woodhouse, A. Mukherjee, S. M. Shalet, and S. Ezzat The Influence of Growth Hormone Status on Physical Impairments, Functional Limitations, and Health-Related Quality of Life in Adults Endocr. Rev., May 1, 2006; 27(3): 287 - 317. [Abstract] [Full Text] [PDF]

				M. E. Molitch, D. R. Clemmons, S. Malozowski, G. R. Merriam, S. M. Shalet, M. L. Vance, and for The Endocrine Society's Clinical Guidelines Su Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1621 - 1634. [Abstract] [Full Text] [PDF]

				A. F. Attanasio, E. P. Shavrikova, W. F. Blum, and S. M. Shalet Quality of Life in Childhood Onset Growth Hormone-Deficient Patients in the Transition Phase from Childhood to Adulthood J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4525 - 4529. [Abstract] [Full Text] [PDF]

				N. Mauras, O. H. Pescovitz, V. Allada, M. Messig, M. P. Wajnrajch, B. Lippe, and on behalf of the Transition Study Group Limited Efficacy of Growth Hormone (GH) during Transition of GH-Deficient Patients from Adolescence to Adulthood: A Phase III Multicenter, Double-Blind, Randomized Two-Year Trial J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3946 - 3955. [Abstract] [Full Text] [PDF]

				P E Clayton, R C Cuneo, A Juul, J P Monson, S M Shalet, and M Tauber Consensus statement on the management of the GH-treated adolescent in the transition to adult care Eur. J. Endocrinol., February 1, 2005; 152(2): 165 - 170. [Abstract] [Full Text] [PDF]

				H K Gleeson and S M Shalet The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours Endocr. Relat. Cancer, December 1, 2004; 11(4): 589 - 602. [Abstract] [Full Text] [PDF]

				A. F. Attanasio, E. Shavrikova, W. F. Blum, M. Cromer, C. J. Child, M. Paskova, J. Lebl, J. J. Chipman, the Hypopituitary Developmental Outcome Study Grou, and S. M. Shalet Continued Growth Hormone (GH) Treatment after Final Height Is Necessary to Complete Somatic Development in Childhood-Onset GH-Deficient Patients J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 4857 - 4862. [Abstract] [Full Text] [PDF]

				R. Bouillon, E. Koledova, O. Bezlepkina, J. Nijs, E. Shavrikhova, E. Nagaeva, O. Chikulaeva, V. Peterkova, I. Dedov, A. Bakulin, et al. Bone Status and Fracture Prevalence in Russian Adults with Childhood-Onset Growth Hormone Deficiency J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 4993 - 4998. [Abstract] [Full Text] [PDF]

				K.-C. Leung, G. Johannsson, G. M. Leong, and K. K. Y. Ho Estrogen Regulation of Growth Hormone Action Endocr. Rev., October 1, 2004; 25(5): 693 - 721. [Abstract] [Full Text] [PDF]

				H. K. Gleeson, H. R. Gattamaneni, L. Smethurst, B. M. Brennan, and S. M. Shalet Reassessment of Growth Hormone Status Is Required at Final Height in Children Treated with Growth Hormone Replacement after Radiation Therapy J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 662 - 666. [Abstract] [Full Text] [PDF]

				A. M. Boot Body Composition and Bone Mineral Density in Adolescents with Partial Growth Hormone Deficiency J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5099 - 5100. [Full Text] [PDF]

				M. B. Ranke, A. Lindberg, D. D. Martin, B. Bakker, P. Wilton, K. Albertsson-Wikland, C. T. Cowell, D. A. Price, and E. O. Reiter The Mathematical Model for Total Pubertal Growth in Idiopathic Growth Hormone (GH) Deficiency Suggests a Moderate Role of GH Dose J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4748 - 4753. [Abstract] [Full Text] [PDF]

				S. M. Shalet, E. Shavrikova, M. Cromer, C. J. Child, E. Keller, J. Zapletalova, T. Moshang, W. F. Blum, J. J. Chipman, C. A. Quigley, et al. Effect of Growth Hormone (GH) Treatment on Bone in Postpubertal GH-Deficient Patients: A 2-Year Randomized, Controlled, Dose-Ranging Study J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4124 - 4129. [Abstract] [Full Text] [PDF]

				E. Kajantie, C. H. D. Fall, M. Seppala, R. Koistinen, L. Dunkel, H. Yliharsila, C. Osmond, S. Andersson, D. J. P. Barker, T. Forsen, et al. Serum Insulin-like Growth Factor (IGF)-I and IGF-Binding Protein-1 in Elderly People: Relationships with Cardiovascular Risk Factors, Body Composition, Size at Birth, and Childhood Growth J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 1059 - 1065. [Abstract] [Full Text] [PDF]