Anders Tidblad1, Jan Gustafsson2, Claude Marcus3, Martin Ritzén4, Klas Ekström5. 1. Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet, H2:00, SE-17176 Stockholm, Sweden. Electronic address: anders.tidblad@ki.se. 2. Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: jan.gustafsson@kbh.uu.se. 3. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, B62, SE-141 86 Stockholm, Sweden. Electronic address: claude.marcus@ki.se. 4. Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet, H2:00, SE-17176 Stockholm, Sweden. Electronic address: martin.ritzen@ki.se. 5. Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet, H2:00, SE-17176 Stockholm, Sweden. Electronic address: klas.ekstrom@karolinska.se.
Abstract
OBJECTIVE: Severe growth hormone deficiency (GHD) leads to several metabolic effects in the body ranging from abnormal body composition to biochemical disturbances. However, less is known regarding these parameters in short children with GH peak levels in the lower normal range during provocation tests. Our aim was to study the metabolic profile of this group and compare it with that of healthy children of normal height. DESIGN: Thirty-five pre-pubertal short children (<-2.5 SDS) aged between 7 and 10years, with peak levels of GH between 7 and 14μg/L in an arginine insulin tolerance test (AITT), were compared with twelve age- and sex-matched children of normal height. The metabolic profile of the subjects was analysed by blood samples, DEXA, frequently sampled intravenous glucose tolerance test, microdialysis and stable isotope examinations of rates of glucose production and lipolysis. RESULTS: There were no overall significant metabolic differences between the groups. However, in the subgroup analysis, the short children with GH peaks <10μg/L had significantly lower fasting insulin levels which also correlated to other metabolic parameters. CONCLUSION: The short pre-pubertal children with GH peak levels between 7 and 14μg/L did not differ significantly from healthy children of normal height but subpopulations within this group show significant metabolic differences.
OBJECTIVE:Severe growth hormone deficiency (GHD) leads to several metabolic effects in the body ranging from abnormal body composition to biochemical disturbances. However, less is known regarding these parameters in short children with GH peak levels in the lower normal range during provocation tests. Our aim was to study the metabolic profile of this group and compare it with that of healthy children of normal height. DESIGN: Thirty-five pre-pubertal short children (<-2.5 SDS) aged between 7 and 10years, with peak levels of GH between 7 and 14μg/L in an arginine insulin tolerance test (AITT), were compared with twelve age- and sex-matched children of normal height. The metabolic profile of the subjects was analysed by blood samples, DEXA, frequently sampled intravenous glucose tolerance test, microdialysis and stable isotope examinations of rates of glucose production and lipolysis. RESULTS: There were no overall significant metabolic differences between the groups. However, in the subgroup analysis, the short children with GH peaks <10μg/L had significantly lower fasting insulin levels which also correlated to other metabolic parameters. CONCLUSION: The short pre-pubertal children with GH peak levels between 7 and 14μg/L did not differ significantly from healthy children of normal height but subpopulations within this group show significant metabolic differences.