BACKGROUND: Prader-Willi syndrome (PWS) children have impaired growth, and abnormal body composition. Previous 1-year controlled studies showed improvement of height and body composition during GH-treatment. OBJECTIVE: To evaluate growth, body composition and body proportions during GH-treatment in a large group of PWS children. DESIGN/PATIENTS: We performed a randomized controlled GH trial in 91 prepubertal PWS children (42 infants, 49 children, aged 3-14 years). After stratification for age, infants were randomized to GH-treatment (GH-group; 1 mg/m(2)/day; n = 20), or no treatment (control group; n = 22) for 1 year. In the second year all infants were treated with GH. After stratification for BMI, children > 3 years of age were randomized to GH-treatment (GH-group; 1 mg/m(2)/day; n = 27) or no treatment (control group; n = 22) for 2 years. Anthropometric parameters were assessed once in every 3 months. Body composition was measured by Dual Energy X-ray Absorptiometry. RESULTS:Median (interquartile range, iqr) height SDS increased during 2 years of GH in infants from -2.3 (-2.8 to -0.7) to -0.4 (-1.1-0.0) and in prepubertal children from -2.0 (-3.1 to -1.7) to -0.6 (-1.1 to -0.1). In non-GH-treated children height SDS did not increase. Head circumference completely normalized during 1 and 2 years of GH in infants and children, respectively. Body fat percentage and body proportions improved in GH-treated children, but did not completely normalize. Lean body mass SDS improved compared to the control group. Serum IGF-I increased to levels above the normal range in most GH-treated children. CONCLUSIONS: Our randomized study shows that GH-treatment in PWS children significantly improves height, BMI, head circumference, body composition and body proportions. PWS children are highly sensitive to GH, suggesting that monitoring of serum IGF-I is indicated.
RCT Entities:
BACKGROUND:Prader-Willi syndrome (PWS) children have impaired growth, and abnormal body composition. Previous 1-year controlled studies showed improvement of height and body composition during GH-treatment. OBJECTIVE: To evaluate growth, body composition and body proportions during GH-treatment in a large group of PWSchildren. DESIGN/PATIENTS: We performed a randomized controlled GH trial in 91 prepubertal PWSchildren (42 infants, 49 children, aged 3-14 years). After stratification for age, infants were randomized to GH-treatment (GH-group; 1 mg/m(2)/day; n = 20), or no treatment (control group; n = 22) for 1 year. In the second year all infants were treated with GH. After stratification for BMI, children > 3 years of age were randomized to GH-treatment (GH-group; 1 mg/m(2)/day; n = 27) or no treatment (control group; n = 22) for 2 years. Anthropometric parameters were assessed once in every 3 months. Body composition was measured by Dual Energy X-ray Absorptiometry. RESULTS: Median (interquartile range, iqr) height SDS increased during 2 years of GH in infants from -2.3 (-2.8 to -0.7) to -0.4 (-1.1-0.0) and in prepubertal children from -2.0 (-3.1 to -1.7) to -0.6 (-1.1 to -0.1). In non-GH-treated children height SDS did not increase. Head circumference completely normalized during 1 and 2 years of GH in infants and children, respectively. Body fat percentage and body proportions improved in GH-treated children, but did not completely normalize. Lean body mass SDS improved compared to the control group. Serum IGF-I increased to levels above the normal range in most GH-treated children. CONCLUSIONS: Our randomized study shows that GH-treatment in PWSchildren significantly improves height, BMI, head circumference, body composition and body proportions. PWSchildren are highly sensitive to GH, suggesting that monitoring of serum IGF-I is indicated.
Authors: V Pampanini; A Boiani; C De Marchis; C Giacomozzi; R Navas; R Agostino; F Dini; P Ghirri; S Cianfarani Journal: Eur J Pediatr Date: 2014-06-24 Impact factor: 3.183
Authors: Jennifer Proffitt; Kathryn Osann; Barbara McManus; Virginia E Kimonis; Janalee Heinemann; Merlin G Butler; David A Stevenson; June-Anne Gold Journal: Am J Med Genet A Date: 2018-12-19 Impact factor: 2.802
Authors: Aaron L Carrel; Susan E Myers; Barbara Y Whitman; Jens Eickhoff; David B Allen Journal: J Clin Endocrinol Metab Date: 2010-01-08 Impact factor: 5.958