Effect of growth hormone treatment on energy expenditure and its relation to first-year growth response in children

Biological effects of recombinant human growth hormone therapy on metabolism in children with growth hormone deficiency: a review

INTRODUCTION

Recombinant human growth hormone (rhGH) therapy (GHT) for short stature resulting from growth hormone deficiency (GHD) is effective in promoting optimal growth velocity and achieving an appropriate final height. However, the specific metabolic changes in children during replacement GHT remain unclear.

CONTENT

The study aimed to evaluate the effects of GHT on metabolism in children with GHD. This is a review of the literature published at PubMed/MEDLINE between January 2010 and August 2024, including original articles. The authors searched Medline using the following keywords: growth hormone therapy in children OR growth hormone treatment in children AND metabolism OR glycemia OR glycated hemoglobin OR insulin OR lipid profile OR blood pressure OR bone mineral density OR body mass index OR waist circumference OR hip circumference OR waist-to-hip ratio OR lean body mass OR visceral fat OR muscle strength OR physical activity OR exercise.

SUMMARY AND OUTLOOK

GHT in children positively affects the lipid profile and body composition. Nevertheless, rhGH treatment may increase fasting glucose, glycated hemoglobin, and indices of insulin resistance. GHT in children has not been associated with an increased risk of diabetes. No changes in blood pressure during GHT were observed. The results of our review show that GHT impacts lipid profiles, carbohydrate metabolism, and body composition. Further studies are needed to clarify the molecular mechanisms by which GH regulates substrate metabolism.

Insulin and Growth Hormone Balance: Implications for Obesity

Disruption of endocrine hormonal balance (i.e., increased levels of insulin, and reduced levels of growth hormone, GH) often occurs in pre-obesity and obesity. Using distinct intracellular signaling pathways to control cell and body metabolism, GH and insulin also regulate each other's secretion to maintain overall metabolic homeostasis. Therefore, a comprehensive understanding of insulin and GH balance is essential for understanding endocrine hormonal contributions to energy storage and utilization. In this review we summarize the actions of, and interactions between, insulin and GH at the cellular level, and highlight the association between the insulin/GH ratio and energy metabolism, as well as fat accumulation. Use of the [insulin]:[GH] ratio as a biomarker for predicting the development of obesity is proposed.