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Metabolic parameters and adipokine profile during GH replacement therapy in children with GH deficiency

U.O. per la Diagnosi e Cura delle Endocrinopatie Autoimmuni e del Diabete di Tipo uno, Sezione di Endocrinologia, Dipartimento di Oncologia Sperimentale e Applicazioni Cliniche (DOSAC), Facoltà di Medicina e Chirurgia, Università degli Studi di Palermo, Palermo, Italy

(Correspondence should be addressed to C Giordano who is now at Endocrinology, DOSAC Faculty of Medicine Università degli Studi, Palermo 90127, Italy; Email: cgiordan{at}unipa.it)

Objective: GH replacement therapy in children with GH deficiency (GHD) mainly promotes linear growth. Not only have very few studies fully analyzed the metabolic consequences of GH therapy, but also the question as to whether GH may affect adipokine secretion has been insufficiently investigated. Our aim was to study the effects of GH replacement therapy on auxological data, lipid and glycemic profiles, insulin homeostasis (HOMA-IR) and serum adipokines in children.

Methods: This was a 1-year prospective study. Thirty-four GHD children (11.6 ± 2.6 years) and thirty healthy matched controls were enrolled. Children affected by GHD were studied both before beginning continuous GH replacement therapy and again at 12 months.

Results: At the beginning of the study, total and LDL cholesterol were higher in GHD children than in controls (P<0.001), whereas HDL cholesterol, triglycerides, insulin, HOMA-IR, leptin, and adiponectin were similar. At 12 months of continuous GH replacement therapy in the GHD group, there was a significant increase in both auxological data and IGF-I (P<0.001); total cholesterol (P<0.001), LDL (P<0.001), triglycerides (P<0.005), and leptin (P<0.001) decreased significantly; HDL (P<0.003), insulin (P<0.001), HOMA-IR (P<0.001) increased while adiponectin was unmodified. Furthermore, IGF-I showed an inverse correlation with leptin ( = –0.398, P = 0.02).

Conclusions: In GHD children, the evaluation of metabolic parameters proves to be a useful tool for the evaluation of auxological parameters during GH replacement therapy. In our study, GH replacement therapy in GHD children improved final height, restored IGF-I levels, reduced leptin levels, and improved the lipid profile, without producing any unfavorable effects on glucose metabolism.