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Adolescents with Partial Growth Hormone (GH) Deficiency Develop Alterations of Body Composition after GH Discontinuation and Require Follow-Up

Unit of Endocrinology (M.T., B.J., A.C., N.L., M.G., C.M., C.P., I.O., P.M., P.R.), Hôpital des Enfants, TSA 70034, 31059 Toulouse Cedex 9, France; Unit of Radiology (P.O., F.J.), Centre Hospitalier Universitaire Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France; and Unit 558 of Epidemiology of Institut National de la Santé et de la Recherche Médicale (C.A.), Hôpital Paule de Viguier, TSA 70034, 31059 Toulouse Cedex 9, France

Address all correspondence and requests for reprints to: Professor M. Tauber, Unit of Endocrinology, Hôpital des enfants, 330 Avenue de Grande Bretagne, BP 3119, 31026 Toulouse Cedex 3, France. E-mail tauber.mt{at}chu-toulouse.fr.

It is now a consensus to resume GH treatment in adolescents with severe GH deficiency (GHD) at retesting to prevent the occurrence of adult GHD syndrome. However, we do not have any data on the follow-up of adolescents with nonsevere GHD at completion of treatment. This report presents preliminary data from a 1-yr prospective study that includes the first 91 patients retested. Anthropometric data, IGF-I and IGF binding protein-3 levels, glycemia and insulinemia, lipid profile, and body composition using dual x-ray absorptiometry and abdominal computed tomography scan were recorded at completion of GH treatment and 1 yr later. Body composition was significantly different at both evaluations, with increased total body fat and decreased lean body mass in the partial GHD group vs. the normal group. Moreover, these alterations worsened after 1 yr without GH in the partial GHD group, whereas there were no modifications in the normal group. We did not find any metabolic alterations such as elevated triglyceride, total cholesterol, or insulin levels. Adolescents with reconfirmed partial GHD exhibit alterations in body composition after 1 yr without GH, whereas those retested normal do not. These changes are similar to those described in severe GHD, although less marked, and justify a precise follow-up.

Abbreviations: AO-GHD, Adult-onset GHD; Apo, apolipoprotein; BMD, bone mineral density; BMI, body mass index; CO-GHD, childhood-onset GHD; CT, computed tomography; GHD, GH deficiency; HDL, high-density lipoprotein; IGFBP, IGF binding protein; IRMA, immunoradiometric assay; ITT, insulin tolerance test; LBM, lean body mass; LDL, low-density lipoprotein; SDS, SD score(s); TBF, total body fat; TG, triglycerides.

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