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Idiopathic short stature and growth hormone sensitivity in prepubertal children
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.ORCID iD: 0000-0003-1226-1956
Univ Auckland, Liggins Inst, Auckland, New Zealand.
Univ Auckland, Liggins Inst, Auckland, New Zealand.
Univ Auckland, Liggins Inst, Auckland, New Zealand.
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2019 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 91, no 1, p. 110-117Article in journal (Refereed) Published
Abstract [en]

Objective: We compared growth hormone sensitivity to an insulin-like growth factor I (IGF-I) generation test in children with idiopathic short stature (ISS) and of normal stature (NS) across the birthweight range.

Methods: Forty-six prepubertal children (~7.1 years) born at term were studied: ISS (n = 23; 74% boys) and NS (n = 23; 57% boys). Children underwent a modified IGF-I generation test with recombinant human growth hormone (rhGH; 0.05 mg/kg/d) over four consecutive days. Hormonal concentrations were measured at baseline and day 5.

Results: Children with idiopathic short stature were 1.90 SDS lighter (P < 0.0001) but had 4.5% more body fat (P = 0.0007) than NS children. Overall, decreasing birthweight SDS across the normal range (-1.9 to +1.5 SDS) was associated with lower percentage IGF-I response to rhGH stimulation in univariable (r = 0.45; P = 0.002) and multivariable models (β = 24.6; P = 0.006). Plasma IGF-I concentrations rose in both groups with rhGH stimulation (P < 0.0001). GHBP levels (P = 0.002) were suppressed in ISS children (-19%; P = 0.029) but increased among NS children (+18%; P = 0.028), with contrasting responses also observed for leptin and IGFBP-1. Further, the increase in insulin concentrations in response to rhGH stimulation was ~3-fold greater in NS children (142% vs 50%; P = 0.006).

Conclusions: A progressive decrease in birthweight SDS was associated with a reduction in GH sensitivity in both NS and ISS children. Thus, the lower IGF-I response to rhGH stimulation in association with decreasing birthweight indicates that the ISS children at the lower end of the birthweight spectrum may have partial GH resistance, which may contribute to their poorer growth.

Place, publisher, year, edition, pages
2019. Vol. 91, no 1, p. 110-117
Keywords [en]
growth hormone binding globulin, height, insulin-like growth factor I, recombinant human growth hormone, sensitivity
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-388758DOI: 10.1111/cen.13976ISI: 000471601200014PubMedID: 30908679OAI: oai:DiVA.org:uu-388758DiVA, id: diva2:1342775
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-08-14Bibliographically approved

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Derraik, Jose G. B.

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