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Maniatis A, Cutfield W, Dattani M, Deal C, Collett-Solberg PF, Horikawa R, Maghnie M, Miller BS, Polak M, Sävendahl L, Woelfle J. Long-Acting Growth Hormone Therapy in Pediatric Growth Hormone Deficiency: A Consensus Statement. J Clin Endocrinol Metab 2025; 110:e1232-e1240. [PMID: 39672599 PMCID: PMC11913077 DOI: 10.1210/clinem/dgae834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Indexed: 12/15/2024]
Abstract
CONTEXT Several long-acting growth hormone (LAGH) therapies have recently become available, but guidance on their usage in children with growth hormone (GH) deficiency is limited. METHODS International experts in pediatric endocrinology were invited to join a consensus group based on their expertise in treating children with daily GH and LAGH. The group comprised 11 experts from 10 countries across the world. Online group meetings were held in February to March 2024 followed by a 1-day in-person meeting in May 2024 to finalize the consensus recommendations. A targeted literature search approach was used to identify and share evidence ahead of the meetings. Formulations considered were limited to those with international populations in phase III pivotal trials and regulatory approvals in multiple countries. EVIDENCE SYNTHESIS Topics covered include patient selection and preference, dose adjustment, initiating and switching therapies, administration, adherence and missed doses, practical considerations, and knowledge gaps. LAGH formulations offer a potential advantage over daily GH injections for children with GH deficiency in terms of reduced injection frequency and treatment burden; this may also be associated with improved adherence and treatment outcomes over time. However, data on LAGH in pediatric GH deficiency are mostly limited to clinical trials, and long-term, real-world data are currently lacking. CONCLUSION This article provides an international consensus on the use of LAGH therapy in children with GH deficiency to guide practitioners when considering these new treatment options for their patients. Long-term data are needed to fill current data gaps and allow the creation of comprehensive evidence-based recommendations.
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Affiliation(s)
| | - Wayne Cutfield
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Mehul Dattani
- Genetics and Genomic Medicine Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Cheri Deal
- Centre de recherche CHU Ste-Justine, Université de Montréal, Montréal H3T 1C5, Canada
| | - Paulo Ferrez Collett-Solberg
- Disciplina de Endocrinologia, Departamento de Medicina Interna, Faculdade de Ciências Medicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, Brazil
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genova, 16147 Genova, Italy
| | - Bradley S Miller
- Division of Endocrinology, Department of Pediatrics, University of Minnesota Medical School, M Health Fairview Masonic Children's Hospital, Minneapolis, MN 55454, USA
| | - Michel Polak
- Service d’Endocrinologie, Gynécologie et Diabétologie Pédiatriques, Hôpital Universitaire Necker Enfants Malades, AP-HP, Université Paris Cité, 75015 Paris, France
| | - Lars Sävendahl
- Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Joachim Woelfle
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, 91054 Erlangen, Germany
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Plachy L, Dusatkova P, Amaratunga SA, Neuman V, Sumnik Z, Lebl J, Pruhova S. Monogenic causes of familial short stature. Front Endocrinol (Lausanne) 2024; 15:1506323. [PMID: 39749023 PMCID: PMC11693446 DOI: 10.3389/fendo.2024.1506323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 11/21/2024] [Indexed: 01/04/2025] Open
Abstract
Genetic factors play a crucial role in determining human height. Short stature commonly affects multiple family members and therefore, familial short stature (FSS) represents a significant proportion of growth disorders. Traditionally, FSS was considered a benign polygenic condition representing a subcategory of idiopathic short stature (ISS). However, advancements in genetic research have revealed that FSS can also be monogenic, inherited in an autosomal dominant manner and can result from different mechanisms including primary growth plate disorders, growth hormone deficiency/insensitivity or by the disruption of fundamental intracellular pathways. These discoveries have highlighted a broader phenotypic spectrum for monogenic forms of short stature, which may exhibit mild manifestations indistinguishable from ISS. Given the overlapping features and the difficulty in differentiating polygenic from monogenic FSS without genetic testing, some researchers redefine FSS as a descriptive term that encompasses any familial occurrence of short stature, regardless of the underlying cause. This shift emphasizes the complexity of diagnosing and managing short stature within families, reflecting the diverse genetic landscape that influences human growth.
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Affiliation(s)
| | | | - Shenali Anne Amaratunga
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czechia
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Atıcı A, Kanık A, Çelik Y, Helvacı İ. Intrauterine Growth References for Turkish Infants. Turk Arch Pediatr 2024; 59:270-276. [PMID: 39140875 PMCID: PMC11181255 DOI: 10.5152/turkarchpediatr.2024.23313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/28/2024] [Indexed: 08/15/2024]
Abstract
Fetal growth is known to be affected by ethnic and environmental factors; therefore, intrauterine growth references for each community vary and need to be determined individually. This study aimed to construct intrauterine growth references for Turkish infants. This prospective, multicenter, cross-sectional study was performed in collaboration with the Turkish Ministry of Health and the Turkish Neonatology Society, in coordination with Mersin University. The study included 33 healthcare centers from all regions of Türkiye. The study included singleton infants who were born alive at 24-42 weeks of gestation. Weight, length, and head circumference were measured within the first 4 hours of delivery. The Lambda-Mu-Sigma method and penalized likelihood were used to establish the curves and construct percentiles. In all, data from 10 286 infants were analyzed and 552 cases that did not meet the inclusion criteria were excluded. The intrauterine growth curves and tables for Turkish infants were constructed using the data for 9734 singleton infants born at 24-42 weeks of gestation. To the best of our knowledge this is the first study to establish intrauterine growth references for Turkish infants, based on a cohort of infants from all regions of Türkiye. Using these new references, the intrauterine growth of Turkish infants and postnatal growth of those born prematurely can be followed-up more effectively, and it will be possible to more accurately determine if Turkish infants are small for gestational age or large for gestational age.
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Affiliation(s)
- Aytuğ Atıcı
- Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin, Türkiye
| | - Arzu Kanık
- Department of Biostatistics and Medical Informatics, Mersin University School of Medicine, Mersin, Türkiye
| | - Yalçın Çelik
- Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin, Türkiye
| | - İlter Helvacı
- Department of Business Information Management, Silifke School of Applied Technology and Management, University of Mersin, Mersin, Türkiye
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Hudson J, Cruickshank M, Quinton R, Aucott L, Wu F, Grossmann M, Bhasin S, Snyder PJ, Ellenberg SS, Travison TG, Brock GB, Gianatti EJ, van der Schouw YT, Emmelot-Vonk MH, Giltay EJ, Hackett G, Ramachandran S, Svartberg J, Hildreth KL, Antonic KG, Tenover JL, Tan HM, Ho Chee Kong C, Tan WS, Marks LS, Ross RJ, Schwartz RS, Manson P, Roberts SA, Skovsager Andersen M, Velling Magnussen L, Aceves-Martins M, Gillies K, Hernández R, Oliver N, Dhillo WS, Bhattacharya S, Brazzelli M, Jayasena CN. Symptomatic benefits of testosterone treatment in patient subgroups: a systematic review, individual participant data meta-analysis, and aggregate data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2023; 4:e561-e572. [PMID: 37804846 DOI: 10.1016/s2666-7568(23)00169-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Testosterone replacement therapy is known to improve sexual function in men younger than 40 years with pathological hypogonadism. However, the extent to which testosterone alleviates sexual dysfunction in older men and men with obesity is unclear, despite the fact that testosterone is being increasingly prescribed to these patient populations. We aimed to evaluate whether subgroups of men with low testosterone derive any symptomatic benefit from testosterone treatment. METHODS We did a systematic review and meta-analysis to evaluate characteristics associated with symptomatic benefit of testosterone treatment versus placebo in men aged 18 years and older with a baseline serum total testosterone concentration of less than 12 nmol/L. We searched major electronic databases (MEDLINE, Embase, Science Citation Index, and the Cochrane Central Register of Controlled Trials) and clinical trial registries for reports published in English between Jan 1, 1992, and Aug 27, 2018. Anonymised individual participant data were requested from the investigators of all identified trials. Primary (cardiovascular) outcomes from this analysis have been published previously. In this report, we present the secondary outcomes of sexual function, quality of life, and psychological outcomes at 12 months. We did a one-stage individual participant data meta-analysis with a random-effects linear regression model, and a two-stage meta-analysis integrating individual participant data with aggregated data from studies that did not provide individual participant data. This study is registered with PROSPERO, CRD42018111005. FINDINGS 9871 citations were identified through database searches. After exclusion of duplicates and publications not meeting inclusion criteria, 225 full texts were assessed for inclusion, of which 109 publications reporting 35 primary studies (with a total 5601 participants) were included. Of these, 17 trials provided individual participant data (3431 participants; median age 67 years [IQR 60-72]; 3281 [97%] of 3380 aged ≥40 years) Compared with placebo, testosterone treatment increased 15-item International Index of Erectile Function (IIEF-15) total score (mean difference 5·52 [95% CI 3·95-7·10]; τ2=1·17; n=1412) and IIEF-15 erectile function subscore (2·14 [1·40-2·89]; τ2=0·64; n=1436), reaching the minimal clinically important difference for mild erectile dysfunction. These effects were not found to be dependent on participant age, obesity, presence of diabetes, or baseline serum total testosterone. However, absolute IIEF-15 scores reached during testosterone treatment were subject to thresholds in patient age and baseline serum total testosterone. Testosterone significantly improved Aging Males' Symptoms score, and some 12-item or 36-item Short Form Survey quality of life subscores compared with placebo, but it did not significantly improve psychological symptoms (measured by Beck Depression Inventory). INTERPRETATION In men aged 40 years or older with baseline serum testosterone of less than 12 nmol/L, short-to-medium-term testosterone treatment could provide clinically meaningful treatment for mild erectile dysfunction, irrespective of patient age, obesity, or degree of low testosterone. However, due to more severe baseline symptoms, the absolute level of sexual function reached during testosterone treatment might be lower in older men and men with obesity. FUNDING National Institute for Health and Care Research Health Technology Assessment Programme.
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Affiliation(s)
- Jemma Hudson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Richard Quinton
- Translational & Clinical Research Institute, University of Newcastle, Newcastle upon Tyne, UK
| | - Lorna Aucott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Frederick Wu
- Division of Diabetes, Endocrinology & Gastroenterology, University of Manchester, Manchester, UK
| | - Mathis Grossmann
- University of Melbourne Austin Health, Heidelberg, VIC, Australia
| | | | - Peter J Snyder
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan S Ellenberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Gerald B Brock
- Department of Surgery, Western University and Omega Fertility Center, London, ON, Canada
| | - Emily J Gianatti
- Department of Endocrinology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Marielle H Emmelot-Vonk
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
| | - Geoff Hackett
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Johan Svartberg
- Division of Internal Medicine, Section of Endocrinology, University Hospital of North Norway, Tromsø, Norway; Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kerry L Hildreth
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kristina Groti Antonic
- Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Joyce Lisa Tenover
- Geriatric Medicine, VA Palo Alto Health Care System, Palo Alto, CA, USA; School of Medicine, Stanford University, Stanford, CA, USA
| | - Hui Meng Tan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Wei Shen Tan
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Leonard S Marks
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard J Ross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Robert S Schwartz
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Paul Manson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | | | | | | | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Rodolfo Hernández
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nick Oliver
- Faculty of Medicine, Imperial College London, London, UK
| | | | - Siladitya Bhattacharya
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Plachy L, Petruzelkova L, Dusatkova P, Maratova K, Zemkova D, Elblova L, Neuman V, Kolouskova S, Obermannova B, Snajderova M, Sumnik Z, Lebl J, Pruhova S. Analysis of children with familial short stature: who should be indicated for genetic testing? Endocr Connect 2023; 12:e230238. [PMID: 37561071 PMCID: PMC10563636 DOI: 10.1530/ec-23-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/10/2023] [Indexed: 08/11/2023]
Abstract
Familial short stature (FSS) describes vertically transmitted growth disorders. Traditionally, polygenic inheritance is presumed, but monogenic inheritance seems to occur more frequently than expected. Clinical predictors of monogenic FSS have not been elucidated. The aim of the study was to identify the monogenic etiology and its clinical predictors in FSS children. Of 747 patients treated with growth hormone (GH) in our center, 95 with FSS met the inclusion criteria (pretreatment height ≤-2 SD in child and his/her shorter parent); secondary short stature and Turner/Prader-Willi syndrome were excluded criteria. Genetic etiology was known in 11/95 children before the study, remaining 84 were examined by next-generation sequencing. The results were evaluated by American College of Medical Genetics and Genomics (ACMG) guidelines. Nonparametric tests evaluated differences between monogenic and non-monogenic FSS, an ROC curve estimated quantitative cutoffs for the predictors. Monogenic FSS was confirmed in 36/95 (38%) children. Of these, 29 (81%) carried a causative genetic variant affecting the growth plate, 4 (11%) a variant affecting GH-insulin-like growth factor 1 (IGF1) axis and 3 (8%) a variant in miscellaneous genes. Lower shorter parent's height (P = 0.015) and less delayed bone age (BA) before GH treatment (P = 0.026) predicted monogenic FSS. In children with BA delayed less than 0.4 years and with shorter parent's heights ≤-2.4 SD, monogenic FSS was revealed in 13/16 (81%) cases. To conclude, in FSS children treated with GH, a monogenic etiology is frequent, and gene variants affecting the growth plate are the most common. Shorter parent's height and BA are clinical predictors of monogenic FSS.
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Affiliation(s)
- Lukas Plachy
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Lenka Petruzelkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Petra Dusatkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Klara Maratova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Dana Zemkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Lenka Elblova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Vit Neuman
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Stanislava Kolouskova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Barbora Obermannova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Marta Snajderova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Zdenek Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Jan Lebl
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
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Piazza VG, Cicconi NS, Martinez CS, Dominici FP, Miquet JG, Sotelo AI. Liver impact of growth hormone (GH) intermittent treatment during the growth period in mice. Mol Cell Endocrinol 2023; 566-567:111911. [PMID: 36905979 DOI: 10.1016/j.mce.2023.111911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/08/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023]
Abstract
Liver impact of prolonged GH-treatment given to non-GH-deficient growing mice between the third and eighth week of life was evaluated in both sexes. Tissues were collected 6 h after last dose or four weeks later. Somatometric, biochemical, histological, immunohistochemical, RT-qPCR and immunoblotting determinations were performed. Five-week GH intermittent administration induced body weight gain and body and bone length increase, augmented organ weight, higher hepatocellular size and proliferation, and increased liver IGF1 gene expression. Phosphorylation of signaling mediators and expression of GH-induced proliferation-related genes was decreased in GH-treated mice liver 6h after last injection, reflecting active sensitization/desensitization cycles. In females, GH elicited EGFR expression, associated to higher EGF-induced STAT3/5 phosphorylation. Four weeks after treatment, increased organ weight concomitant to body weight gain was still observed, whereas hepatocyte enlargement reverted. However, basal signaling for critical mediators was lower in GH-treated animals and in male controls compared to female ones, suggesting signaling declination.
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Affiliation(s)
- Verónica G Piazza
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nadia S Cicconi
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carolina S Martinez
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernando P Dominici
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Johanna G Miquet
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ana I Sotelo
- Departamento de Química Biológica, Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina.
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Ea C, Hennocq Q, Picard A, Polak M, Collet C, Legeai-Mallet L, Arnaud É, Paternoster G, Khonsari RH. Growth charts in FGFR2- and FGFR3-related faciocraniosynostoses. Bone Rep 2022; 16:101524. [PMID: 35372644 PMCID: PMC8965158 DOI: 10.1016/j.bonr.2022.101524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Faciocraniosynostoses (FCS) are malformations affecting the development of the bones of the skull and face, due to the premature closure of one or more craniofacial sutures, mostly secondary to activating Fibroblast Growth Factor Receptor (FGFR) 1–3 mutations. Gain-of-function FGFR3 mutations are also responsible for various conditions referred to as osteochondrodysplasia (OCD), characterized by structural and functional abnormalities of growth plate cartilages. We hypothesized that patients with FGFR-related faciocraniosynostoses may present extra-cranial growth anomalies. Study design We retrospectively collected height and weight data from a cohort of 70 patients. Included patients were admitted for FGFR-related FCS between 2000 and 2021 at the Craniofacial Unit of Necker – Enfants Malades University Hospital in Paris, France. Results We showed that FGFR-related faciocraniosynostoses had significantly reduced heights and weights relative to controls, and that two specific time periods (1–3 years and > 8 years of age) were associated with lower height and weight values. Four patients had received growth hormone treatment but remained below normal values for growth in height and weight. Conclusions Patients with FGFR-related faciocraniosynostoses have clinically significant extra-cranial anomalies which are not currently investigated and managed in usual protocols; these patients could benefit from a systematic pre-pubertal endocrine assessment. More generally, our results extend the scope of extracranial anomalies in FGFR-related faciocraniosynostoses and support the hypothesis that all conditions with activating FGFR mutations affect both membranous ossification and long bones. FGFR mutations can cause syndromic faciocraniosynostoses (FCS) and are also responsible for osteochondrodysplasia. Patients with FCS present with significant delays in development compared to the standard French population. Patients with FCS could benefit from a systematic pre-pubertal endocrine assessment and hormonotherapy but more data is required to establish guidelines. FCS and achondroplasia both affect membranous and endochondral ossification processes.
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Lack of Catch-Up Growth with Growth Hormone Treatment in a Child Born Small for Gestational Age Leading to a Diagnosis of Noonan Syndrome with a Pathogenic PTPN11 Variant. Case Rep Endocrinol 2021; 2021:5571524. [PMID: 34194850 PMCID: PMC8203378 DOI: 10.1155/2021/5571524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Growth hormone (GH) treatment increases the adult height of short children born small for gestational age (SGA). Catch-up growth is associated with a younger age, shorter height, and prepubertal status at the onset of GH treatment. We report a 12 11/12-year-old girl born SGA who received GH for 5 years without catch-up growth and was diagnosed with Noonan Syndrome (NS). Results A 5-year-and-9-month-old 46, XX girl born SGA was started on GH treatment at a dose of 0.32 mg/kg/week. Her midparental target height is 158.6 cm. Endocrine work up showed an IGF-1 level 69 ng/ml (Normal (N): 55–238 ng/ml), IGFBP3 2.6 mg/L (N: 1.9–5.2 mg/L), TSH 3.2 mIU/L (N: 0.35–5.5 mIU/L), and a normal skeletal survey. Height was 96 cm (0.1%; Ht SDS −2.9), weight 14 kgs (1%; Wt SDS −2.3), and Tanner 1 breast and pubic hair were observed. Due to the poor catch-up growth on GH treatment, she was referred to Genetics to elucidate genetic or syndromic causes of short stature. She was noted to have posteriorly rotated ears and slight down slanting of the palpebral fissures. Genetic findings showed a heterozygous pathogenic variant in PTPN11 (c.922A > G (p.Asn308Asp)) diagnostic for NS. This finding is de novo given negative parental testing. She was noted to have a heterozygous missense variant of unknown significance (VUS) in FGFR3: c.746C > A (p.Ser249Tyr). FGFR3 is associated with multiple skeletal dysplasias including thanatophoric dysplasia, achondroplasia, and Crouzon syndrome and hypochondroplasia. Clinical correlation is poor for these syndromes. Conclusion Diminished catch-up growth and response to GH treatment in a child born SGA led to the diagnosis of NS. The concomitant diagnosis of SGA and NS may have affected the responsiveness of this child to the growth promoting effect of GH treatment.
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Plachy L, Dusatkova P, Maratova K, Petruzelkova L, Elblova L, Kolouskova S, Snajderova M, Obermannova B, Zemkova D, Sumnik Z, Lebl J, Pruhova S. Familial Short Stature-A Novel Phenotype of Growth Plate Collagenopathies. J Clin Endocrinol Metab 2021; 106:1742-1749. [PMID: 33570564 DOI: 10.1210/clinem/dgab084] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Collagens are the most abundant proteins in the human body. In a growth plate, collagen types II, IX, X, and XI are present. Defects in collagen genes cause heterogeneous syndromic disorders frequently associated with short stature. Less is known about oligosymptomatic collagenopathies. OBJECTIVE This work aims to evaluate the frequency of collagenopathies in familial short stature (FSS) children and to describe their phenotype, including growth hormone (GH) treatment response. METHODS Eighty-seven FSS children (pretreatment height ≤ -2 SD both in the patient and his or her shorter parent) treated with GH were included in the study. Next-generation sequencing was performed to search for variants in the COL2A1, COL9A1, COL9A2, COL9A3, COL10A1, COL11A1, and COL11A2 genes. The results were evaluated using American College of Medical Genetics and Genomics guidelines. The GH treatment response of affected children was retrospectively evaluated. RESULTS A likely pathogenic variant in the collagen gene was found in 10 of 87 (11.5%) children. Detailed examination described mild asymmetry with shorter limbs and mild bone dysplasia signs in 2 of 10 and 4 of 10 affected children, respectively. Their growth velocity improved from a median of 5.3 cm/year to 8.7 cm/year after 1 year of treatment. Their height improved from a median of -3.1 SD to -2.6 SD and to -2.2 SD after 1 and 3 years of therapy, respectively. The final height reached by 4 of 10 children differed by -0.67 to +1.0 SD and -0.45 to +0.5 SD compared to their pretreatment height and their affected untreated parent's height, respectively. CONCLUSION Oligosymptomatic collagenopathies are a frequent cause of FSS. The short-term response to GH treatment is promising.
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Affiliation(s)
- Lukas Plachy
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Petra Dusatkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Klara Maratova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Lenka Petruzelkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Lenka Elblova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Stanislava Kolouskova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Marta Snajderova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Barbora Obermannova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Dana Zemkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Zdenek Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Jan Lebl
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, 150 06 Prague 5, Czech Republic
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Das D. Growth Hormone Dynamics among Children with Mixed Gonadal Dysgenesis (45,X/46,XY). ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2021; 17:117-123. [PMID: 34539919 PMCID: PMC8417479 DOI: 10.4183/aeb.2021.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CONTEXT Learn the growth hormone dynamics and discuss the issues of growth hormone therapy in subjects with 45,X/46XY. OBJECTIVE To study the growth hormone dynamics in children with 45,X/46,XY karyotyping and mixed gonadal dysgenesis (MGD). DESIGN Descriptive clinical study. PARTICIPANTS Five subjects with karyotype 45,X / 46,XY with or without genital ambiguity and somatic features of SHOX haploinsufficiency. INTERVENTIONS Growth hormone dynamic study and gonadectomy. MAIN OUTCOME IGF-1, peak GH levels, Turner's stigmata and histology of gonadal tissue. RESULTS Five cases of MGD with both male and female phenotype were studies. IGF-1 levels and GH levels showed both features of growth hormone deficiency and growth hormone insensitivity. One study subject has gonadal germ cell tumour (dysgerminoma). We discuss here the issues regarding the GH therapy in MGD subjects. CONCLUSION Growth deceleration in MGD subjects is partly due to defective growth hormone secretion and partly due to growth hormone insensitivity. MGD subjects are at high risk for occurrence of gonadal tumours. Gonadectomy or biopsy of underlying dysgenetic gonads is essential prior GH therapy. Close surveillance for second neoplasm is to be considered in subjects with history of gonadal tumors prior starting GH for short stature.
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Affiliation(s)
- D. Das
- Government Medical College Thiruvananthapuram - Endocrinology, Kerala, India
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11
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Developmental Abnormalities of the Skull Base in Patients with Turner Syndrome. CURRENT HEALTH SCIENCES JOURNAL 2021; 46:329-335. [PMID: 33717506 PMCID: PMC7948014 DOI: 10.12865/chsj.46.04.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/18/2020] [Indexed: 12/02/2022]
Abstract
The skull base is one of the most complex anatomic structures of the skeleton that is responsible for protecting and supporting the brain and is also involved in the development of the facial structures. The main objective of our study was to evaluate skull base abnormalities in a group of patients diagnosed with Turner syndrome by assessing lateral cephalometric radiographs. A total of 7 patients diagnosed with Turner syndrome in the Endocrinology Department of the Emergency Clinical County Hospital of Craiova were included in the study. The following cephalometric variables were measured in our study: total skull base (N-Ba): Nasion (N)-Basion (Ba); anterior skull base (N-S): Nasion (N)-Sella (S); posterior skull base (S-Ba): Sella (S)-Basion (Ba). Regarding the investigated cephalometric variables, the mean±standard deviation (SD) recorded values in our study were 86.34±4.26mm for the total skull base (N-Ba), 63.87±2.54mm for the anterior skull base (N-S) and 38.33±4.87mm for the posterior skull base (S-Ba). The results of our study were compared to the ones provided by one of the most representative studies described in the literature. A reduced size of the posterior base of the skull is considered pathognomonic in subjects diagnosed with Turner syndrome. Also, the posterior base of the skull directly influences the maxillomandibular skeletal relationships and it is therefore necessary to calculate this cephalometric variable, which is easily highlighted on a lateral cephalometric radiograph.
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12
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Shujaa-Addin A, Hashish M, Nazmy N, Srour A, Abdalla E. Detection of SHOX gene deletions in Egyptian children with idiopathic short stature using FISH. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Al Shaikh A, Daftardar H, Alghamdi AA, Jamjoom M, Awidah S, Ahmed ME, Soliman AT. Effect of growth hormone treatment on children with idiopathic short stature (ISS), idiopathic growth hormone deficiency (IGHD), small for gestational age (SGA) and Turner syndrome (TS) in a tertiary care center. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:29-40. [PMID: 32191651 PMCID: PMC7569569 DOI: 10.23750/abm.v91i1.9182] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To assess the long-term effect of growth hormone (GH) therapy in a large cohort of short children with different etiologies. PATIENTS AND METHODS We evaluated retrospectively the anthropometric data of 252 short children [height SDS <-2: 154 children with growth hormone deficiency (GHD), 63 with idiopathic short stature (ISS), 26 with SGA, and 9 with Turner syndrome (TS)] who were treated, in our center, with GH between 1-2007 and 1-2018. Before and during recombinamt growth-hormone (recGH) treatment, auxological parameters including height (Ht), weight (Wt), Ht - Z score (HtSDS), body mass index (BMI) and BMISDS were recorded every 6 months; bone age (BA) was assessed every 12 months. RESULTS At the end of first year of rhGH therapy and after an average of 3 years treatment all groups of short children had significant increase in HtSDS, which was higher in GHD compared to other groups. Children with GHD, SGA, ISS and TS increased their HtSDS by an average of 2.2, 1.46, 0.6 and 0.99 SD, respectively at the end of follow up period (for all groups, p: <0.001). The bone age/chronological age (BA/CA) ratio did not differ significantly among ISS, GHD and SGA groups after GH therapy. The HtSDS gain was higher in children with GHD compared to other ISS, SGA and TS groups (p:< 0.01; p: 0.015 and p: 0.029, respectively). HtSDS improvement occurred during the first 3 years of rhGH therapy. The BMISDS increased significantly in children with GHD, after 3 years of rhGH therapy (p: < 0.001). After rhGH treatment, the BMISDS decreased significantly in children with ISS and SGA (p: < 0.01 and < 0.001, respectively) but did not change in children with TS (p: 0.199). CONCLUSIONS Children with GHD, SGA, ISS and TS exhibited significant increases in HtSDS when treated with rhGH for 3 years. The HtSDS gain was higher in children with GHD compared to other groups.
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Affiliation(s)
- Adnan Al Shaikh
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Hadeer Daftardar
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Abdul Aziz Alghamdi
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Majd Jamjoom
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Saniah Awidah
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Mohamed E Ahmed
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Ashraf T Soliman
- Professor of Pediatrics and Endocrinology, University of Alexandria, Egypt.
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14
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Plachy L, Dusatkova P, Maratova K, Petruzelkova L, Zemkova D, Elblova L, Kucerova P, Toni L, Kolouskova S, Snajderova M, Sumnik Z, Lebl J, Pruhova S. NPR2 Variants Are Frequent among Children with Familiar Short Stature and Respond Well to Growth Hormone Therapy. J Clin Endocrinol Metab 2020; 105:5716766. [PMID: 31990356 DOI: 10.1210/clinem/dgaa037] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/27/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT The C-type natriuretic peptide receptor encoded by the NPR2 gene is a paracrine regulator of the growth plate; heterozygous NPR2 variants cause short stature with possible presence of different signs of bone dysplasia. To date, the effect of growth hormone (GH) treatment has been described in a few individuals with NPR2 gene variants with inconsistent results. OBJECTIVES To identify NPR2 gene variants among children with familial short stature (FSS) and to describe their phenotype, including GH treatment response. DESIGN, SETTINGS AND PATIENTS Out of 747 patients with short stature treated with GH in a single center, 87 with FSS met the inclusion criteria (pretreatment height ≤ -2 standard deviation in both the patient and the shorter parent, unknown genetic etiology). Next-generation sequencing methods were performed to search for NPR2 gene variants. The results were evaluated using the American College of Medical Genetics and Genomics guidelines. The GH treatment response (growth velocity improvement and height standard deviation score development over the first 5 years of treatment) was evaluated. RESULTS In 5/87 children (5.7%), a (likely) pathogenic variant in the NPR2 gene was identified (p.Ile558Thr [in 2], p.Arg205*, p.Arg557His, p.Ser603Thr). Two children had disproportionate short-limbed short stature, 1 a dysplastic 5th finger phalanx. The growth velocity in the first year of GH treatment accelerated by 3.6 to 4.2 cm/year; the height improved by 1.2 to 1.8 SD over 5 years of treatment. CONCLUSIONS NPR2 gene variants cause FSS in a significant proportion of children. Their GH treatment response is promising. Studies including final height data are necessary to assess the long-term efficacy of this therapy.
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Affiliation(s)
- Lukas Plachy
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Petra Dusatkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Klara Maratova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Lenka Petruzelkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Dana Zemkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Lenka Elblova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Petra Kucerova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Ledjona Toni
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Stanislava Kolouskova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Marta Snajderova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Zdenek Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Jan Lebl
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, 150 06, Czech Republic
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15
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Rodríguez Arnao MD, Rodríguez Sánchez A, Díez López I, Ramírez Fernández J, Bermúdez de la Vega JA, Yeste Fernández D, Chueca Guindulain M, Corripio Collado R, Pérez Sánchez J, Fernández González A, ECOS Spain Study Collaborative Investigator Group. Adherence and long-term outcomes of growth hormone therapy with easypod™ in pediatric subjects: Spanish ECOS study. Endocr Connect 2019; 8:1240-1249. [PMID: 31484160 PMCID: PMC6733364 DOI: 10.1530/ec-19-0325] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/31/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Non-adherence to r-hGH treatments occurs in a variable percentage of subjects. One problem found when evaluating adherence is the great variability in methods of detection and definitions utilized in studies. This study assessed the level of adherence in subjects receiving r-hGH with the easypod™ electronic device. METHODS National, multicenter, prospective and observational study involving 238 subjects (144 with GH deficiency (GHD), and 86 with small for gestational age (SGA), 8 with Turner Syndrome), who received r-hGH with easypod™ for at least 3 months before inclusion. The follow-up period was 4 years. RESULTS Overall adherence was 94.5%; 97.5% after 6 months, 95.3% after 1 year, 93.7% after 2, 94.4% after 3 and 95.5% after 4 years of treatment. No differences in adherence were observed between prepubertal and pubertal groups and GHD and SGA groups. Change in height after 1 and 2 years, change in height SDS after 1 and 2 years, HV after 1 year, HV SDS after at 1 and 4 years, change in BMI after 1 year and change in BMI SDS at 1 and 2 years showed significant correlation with adherence. No significant differences in adherence according to IGF-I levels were found in follow-up visits or between groups. CONCLUSIONS The easypod™ electronic device, apart from being a precise and objective measure of adherence to r-hGH treatment, allows high compliance rates to be achieved over long periods of time. Adherence significantly impacts growth outcomes associated with r-hGH treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - ECOS Spain Study Collaborative Investigator Group
- Pediatric Endocrinology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Hospital Universitario Araba, Araba/Alava, Spain
- Hospital Universitario Príncipe de Asturias, Oviedo, Spain
- Centro Nuevas Tecnologias, Sevilla, Spain
- Hospital Vall d’Hebrón, Barcelona, Spain
- Complejo Hospitalario de Navarra, Pamplona, Spain
- Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
- Merck S.L.U., Madrid, Spain
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Castoldi RC, Ozaki GAT, Garcia TA, Giometti IC, Koike TE, Camargo RCT, Dos Santos Pereira JDA, Constantino CJL, Louzada MJQ, Camargo Filho JCS, Belangero WD. Effects of muscular strength training and growth hormone (GH) supplementation on femoral bone tissue: analysis by Raman spectroscopy, dual-energy X-ray absorptiometry, and mechanical resistance. Lasers Med Sci 2019; 35:345-354. [PMID: 31201667 DOI: 10.1007/s10103-019-02821-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/29/2019] [Indexed: 12/23/2022]
Abstract
The aim of the present study was to verify the effects of muscular strength training and growth hormone (GH) supplementation on femoral bone tissue by Raman spectroscopy (Raman), dual-energy X-ray absorptiometry (DXA), and mechanical resistance (F-max) analysis. A total of 40 male Wistar animals, 60 days old, were used. The animals were distributed into four groups: control (C), control with GH (GHC), muscular strength training (T), and muscular strength training with GH (GHT). Blood samples were collected for the quantification of creatine kinase (CK-MB) and the femurs were removed for analysis by Raman, DXA, and F-max. A more pronounced increase in the bone mineral components was verified in the T group, for all the variables obtained by the Raman (calcium, phosphate, amide, and collagen). In addition, for animals submitted to GH supplementation, there was a reduction in the variable bone mineral density (BMD) obtained by the DXA (p < 0.05). Finally, the animals that received GH supplementation presented a higher F-max, but without statistical significance (p > 0.05). It was concluded that animals that received GH supplementation demonstrated a decrease in BMD. In addition, T alone was able to promote increased calcium, phosphate, amide, and collagen compounds in bone tissue.
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Affiliation(s)
- Robson Chacon Castoldi
- Faculty of Medical Sciences, Universidade Estadual de Campinas- UNICAMP, Tessália Vieira de Camargo Street, 126. Neighbor: Cidade Universitária Zeferino Vaz., Campinas City, State of São Paulo, 13083-887, Brazil.
- Department of Physical Education, Universidade do Oeste Paulista - UNOESTE, Raposo Tavares Road, km 572 - Neighbor: Limoeiro, Presidente Prudente City, State of São Paulo, 19.067-175, Brazil.
- Laboratório de Análise da Plasticidade Muscular - LAPMUS, UNESP/FCT - Campus de Presidente Prudente, Rua Roberto Simonsen, 305, Bairro: Centro Educacional, Presidente Prudente, SP, 19060-900, Brazil.
| | - Guilherme Akio Tamura Ozaki
- Faculty of Medical Sciences, Universidade Estadual de Campinas- UNICAMP, Tessália Vieira de Camargo Street, 126. Neighbor: Cidade Universitária Zeferino Vaz., Campinas City, State of São Paulo, 13083-887, Brazil
| | - Thiago Alves Garcia
- Faculty of Medical Sciences, Universidade Estadual de Campinas- UNICAMP, Tessália Vieira de Camargo Street, 126. Neighbor: Cidade Universitária Zeferino Vaz., Campinas City, State of São Paulo, 13083-887, Brazil
| | - Ines Cristina Giometti
- Faculty of Veterinary Medicine, Universidade do Oeste Paulista - UNOESTE, Raposo Tavares Road, km 572 - Neighbor: Limoeiro, Presidente Prudente City, State of São Paulo, 19.067-175, Brazil
| | - Tatiana Emy Koike
- Department of Physical Therapy, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, campus de Presidente Prudente. Roberto Simonsen Street, 305. Neighbor: Centro Educacional, Presidente Prudente City, State of São Paulo, 19060-900, Brazil
| | - Regina Celi Trindade Camargo
- Department of Physical Therapy, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, campus de Presidente Prudente. Roberto Simonsen Street, 305. Neighbor: Centro Educacional, Presidente Prudente City, State of São Paulo, 19060-900, Brazil
| | - João Domingos Augusto Dos Santos Pereira
- Department of Physics, Chemistry, and Biology, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, campus de Presidente Prudente. Roberto Simonsen Street, 305. Neighbor: Centro Educacional, Presidente Prudente City, State of São Paulo, 19060-900, Brazil
| | - Carlos José Leopoldo Constantino
- Department of Physics, Chemistry, and Biology, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, campus de Presidente Prudente. Roberto Simonsen Street, 305. Neighbor: Centro Educacional, Presidente Prudente City, State of São Paulo, 19060-900, Brazil
| | - Mário Jefferson Quirino Louzada
- Department of Animal Support, Production, and Health, Universidade Estadual Paulista- UNESP, campus de Araçatuba. Clóvis Pestana Street, 793. Neighbor: Ipanema, Araçatuba City, State of São Paulo, 16050-680, Brazil
| | - José Carlos Silva Camargo Filho
- Department of Physical Therapy, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, campus de Presidente Prudente. Roberto Simonsen Street, 305. Neighbor: Centro Educacional, Presidente Prudente City, State of São Paulo, 19060-900, Brazil
| | - William Dias Belangero
- Faculty of Medical Sciences, Universidade Estadual de Campinas- UNICAMP, Tessália Vieira de Camargo Street, 126. Neighbor: Cidade Universitária Zeferino Vaz., Campinas City, State of São Paulo, 13083-887, Brazil
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Tanaka T, Yokoya S, Hoshino Y, Hiro S, Ohki N. Long-term safety and efficacy of daily recombinant human growth hormone treatment in Japanese short children born small for gestational age: final report from an open and multi-center study. Clin Pediatr Endocrinol 2018; 27:145-157. [PMID: 30083031 PMCID: PMC6073065 DOI: 10.1297/cpe.27.145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/14/2018] [Indexed: 12/05/2022] Open
Abstract
Our study aimed at evaluating the safety and efficacy of GH treatment up to near adult height (NAH) for short children born small for gestational age (SGA). This was a multi-center, open-label, long-term extension study after a one-year, randomized, open-label, dose-response study. The primary objective was to assess safety, determined by adverse events and laboratory test parameters. Height parameters were evaluated as a secondary objective. The final data after all patients completed the study were reported. Overall, 61 patients were enrolled in the study. GH treatment was well tolerated. No notable changes in HbA1c levels, oral glucose tolerance tests and glucose metabolism were observed. No new safety concerns related to long-term treatment up to NAH were identified. Twenty patients (11 boys and 9 girls) reached NAH with a mean height of 159.1 cm and 146.9 cm, respectively. The mean change in height SDS from baseline to NAH was +1.9 in boys and +1.8 in girls. Long-term GH treatment for SGA short stature was confirmed to be safe and effective for the normalization of adult height.
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Affiliation(s)
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
| | - Yuko Hoshino
- Clinical Research, Development Japan, Pfizer Japan Inc., Tokyo, Japan
| | - Shintaro Hiro
- Clinical Statistics, Development Japan, Pfizer Japan Inc., Tokyo, Japan
| | - Nobuhiko Ohki
- Medical Affairs, Rare Disease, Pfizer Japan Inc., Tokyo, Japan
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Deal C, Kirsch S, Chanoine JP, Lawrence S, Cummings E, Rosolowsky ET, Marks SD, Jia N, Child CJ. Growth hormone treatment of Canadian children: results from the GeNeSIS phase IV prospective observational study. CMAJ Open 2018; 6:E372-E383. [PMID: 30201821 PMCID: PMC6182101 DOI: 10.9778/cmajo.20180020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Country-specific data on outcomes of treatment with recombinant human growth hormone are lacking. We present such data for children treated with growth hormone in Canada. METHODS We describe characteristics and outcomes of 850 children (mean age at baseline 8.5 yr) treated with growth hormone constituting the Canadian cohort of the multinational phase IV prospective observational Genetics and Neuroendocrinology of Short-stature International Study (GeNeSIS). The diagnosis associated with short stature was as determined by the investigator. Auxological data were evaluated yearly until near-adult height. Adverse events were assessed in all growth-hormone-treated patients. RESULTS The diagnosis ascribed as the cause of short stature was growth hormone deficiency in 526 children (61.9%), predominantly organic rather than idiopathic, particularly congenital pituitary abnormalities and intracranial tumours. All diagnostic groups with sufficient patients for analysis had increased height velocity standard deviation score (SDS) and height SDS during growth hormone treatment. For patients who reached near-adult height (n = 293), the mean height SDS was within the normal range for about 80% of patients with organic growth hormone deficiency (n = 131) or idiopathic growth hormone deficiency (n = 50), 50% of patients with idiopathic short stature (n = 10) and 46% of patients with Turner syndrome (n = 79). Eleven deaths were reported, 7 in patients with organic growth hormone deficiency. Serious adverse events considered related to growth hormone treatment (n = 19) were isolated except for medulloblastoma recurrence (n = 2) and adenoidal hypertrophy (n = 2). INTERPRETATION Growth hormone treatment was effective and had a good safety profile in Canadian children. Growth hormone dosages were lower than in the US and global GeNeSIS cohorts, and a greater proportion of treated Canadian children had organic growth hormone deficiency. STUDY REGISTRATION ClinicalTrials.gov, no. NCT01088412.
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Affiliation(s)
- Cheri Deal
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Susan Kirsch
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Jean-Pierre Chanoine
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Sarah Lawrence
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Elizabeth Cummings
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Elizabeth T Rosolowsky
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Seth D Marks
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Nan Jia
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
| | - Christopher J Child
- University of Montreal and Centre hospitalier universitaire Sainte-Justine (Deal), Montréal, Que.; Lilly Research Laboratories (Kirsch), Toronto, Ont.; Endocrinology and Diabetes Unit (Chanoine), British Columbia Children's Hospital, Vancouver, BC; Division of Endocrinology and Metabolism (Lawrence), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Endocrinology (Cummings), IWK Health Centre, Dalhousie University, Halifax, NS; Division of Endocrinology (Rosolowsky), Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alta.; Department of Pediatrics and Child Health (Marks), Children's Hospital Health Sciences Centre Winnipeg, University of Manitoba, Winnipeg, Man.; Lilly Research Laboratories (Jia), Indianapolis, Ind.; Eli Lilly and Company (Child), Windlesham, UK
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19
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Im M, Kim YD, Han HS. Effect of growth hormone treatment on children with idiopathic short stature and idiopathic growth hormone deficiency. Ann Pediatr Endocrinol Metab 2017; 22:119-124. [PMID: 28690991 PMCID: PMC5495978 DOI: 10.6065/apem.2017.22.2.119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 04/19/2017] [Accepted: 05/12/2017] [Indexed: 12/02/2022] Open
Abstract
PURPOSE There are inconsistencies in the results reported in a small number of previous studies into growth hormone (GH) treatment in Korean children with idiopathic short stature (ISS) and idiopathic growth hormone deficiency (IGHD). Thus, the authors retrospectively compared the effects of GH in ISS and IGHD. METHODS From the medical records of 26 ISS and 30 IGHD children, auxological and biochemical changes including chronologic age (CA), bone age (BA), height standard deviation score (HT-SDS), predicted adult height (PAH), midparental height (MPH), insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-3 (IGFBP-3) were compared. RESULTS Before treatment, IGHD group had younger BA, lower BA/CA ratio, and lower IGF-1 level than those in the ISS group. During GH treatment, the levels of IGF-1 and IGFBP-3 were not different. Although annual BA increment was higher in IGHD group, and annual PAH-SDS increment was higher in ISS group, annual HT-SDS increments were not different. Both HT-SDS and PAH-SDS in the ISS group increased significantly until the end of the second year, and then those were not significantly different from MPH-SDS. In the IGHD group, the HT-SDS showed a significant increase till the end of the second year, and the PAH-SDS was not significantly changed at each year, but both HT-SDS and PAH-SDS were not significantly different from MPH-SDS at the end of the third year. CONCLUSION During GH treatment, both HT-SDS and PAH-SDS approached the genetic target range of MPH-SDS after 2 years in ISS children and 3 years in IGHD children.
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Affiliation(s)
- Minji Im
- Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Yong-Dae Kim
- Department of Preventive Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Heon-Seok Han
- Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
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20
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Davidopoulou S, Chatzigianni A. Craniofacial morphology and dental maturity in children with reduced somatic growth of different aetiology and the effect of growth hormone treatment. Prog Orthod 2017; 18:10. [PMID: 28447324 PMCID: PMC5406315 DOI: 10.1186/s40510-017-0164-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/07/2017] [Indexed: 01/08/2023] Open
Abstract
Children with reduced somatic growth may present various endocrinal diseases, especially growth hormone deficiency (GHD), idiopathic short stature (ISS), chromosomal aberrations, or genetic disorders. In an attempt to normalize the short stature, growth hormone (GH) is administered to these children. The aim of this literature review was to collect information about the craniofacial morphology and dental maturity in these children and to present the existing knowledge on the effect of GH treatment on the above structures. This review demonstrated that regardless of the origin of the somatic growth retardation, these children show similar craniofacial features, such as short length of the cranial base and the mandible, increased lower facial height, retropositioned mandible, and obtuse gonion angle. On the other hand, dental maturation does not demonstrate a specific pattern. Except for the above findings, muscle alterations seem to be present in individuals with short stature, who present low body muscle mass and strength, while studies on their craniofacial muscles seem to be lacking. After GH administration, the exact amount and pattern of craniofacial growth is unpredictable; however, the facial convexity decreases, mandibular length increases, and posterior facial height increases, while tooth eruption remains unaffected. Thus, it is of great importance to gain more insight into the craniofacial growth of treated and untreated children with reduced somatic growth so that the influence of GH therapy on the various craniofacial structures could be ascertained and proper orthodontic treatment could be selected.
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Affiliation(s)
- Sotiria Davidopoulou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
| | - Athina Chatzigianni
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
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21
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Chen CP, Ko TM, Wang LK, Lin SP, Chern SR, Wu PS, Chen YN, Chen SW, Yang CW, Town DD, Lee MS, Wang W. Molecular cytogenetic characterization and prenatal diagnosis of familial Xp22.33 microdeletion encompassing short stature homeobox gene in a male fetus with a favorable outcome. Taiwan J Obstet Gynecol 2017; 56:264-267. [PMID: 28420523 DOI: 10.1016/j.tjog.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Tsang-Ming Ko
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei, Taiwan
| | - Liang-Kai Wang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shuan-Pei Lin
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Department of Early Childhood Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | | | - Yen-Ni Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Wen Yang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Dai-Dyi Town
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Meng-Shan Lee
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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22
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Sánchez Marco SB, de Arriba Muñoz A, Ferrer Lozano M, Labarta Aizpún JI, Garagorri Otero JM. Hormona de crecimiento y síndrome de Turner. An Pediatr (Barc) 2017; 86:81-86. [DOI: 10.1016/j.anpedi.2016.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 01/30/2016] [Accepted: 02/24/2016] [Indexed: 11/27/2022] Open
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23
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Human growth hormone and Turner syndrome. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.anpede.2016.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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24
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John M, Koledova E, Kumar KMP, Chaudhari H. Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India. Int J Endocrinol 2016; 2016:2967578. [PMID: 27867396 PMCID: PMC5102730 DOI: 10.1155/2016/2967578] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/15/2016] [Indexed: 12/16/2022] Open
Abstract
In clinical practice, every year approximately 150,000 children are referred with short stature (SS) based on a cut-off of fifth percentile. The most important endocrine and treatable cause of SS is growth hormone deficiency (GHD). The lack of reliable data on the prevalence of GHD in India limits estimation of the magnitude of this problem. The diagnosis and treatment of GHD are hurdled with various challenges, restricting the availability of growth hormone (GH) therapy to only a very limited segment of the children in India. This review will firstly summarize the gaps and challenges in diagnosis and treatment of GHD based on literature analysis. Subsequently, it presents suggestions from the members at advisory board meetings to overcome these challenges. The advisory board suggested that early initiation of the therapy could better the chances of achieving final adult height within the normal range for the population. Education and awareness about growth disorders among parents, regular training for physicians, and more emphasis on using the Indian growth charts for growth monitoring would help improve the diagnosis and treatment of children with GHD. Availability of an easy-to-use therapy delivery system could also be beneficial in improving adherence and achieving satisfactory outcomes.
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Affiliation(s)
- Mathew John
- Providence Endocrine and Diabetes Specialty Centre, Thiruvananthapuram, Kerala, India
| | - Ekaterina Koledova
- Lead Endocrinology, Global Medical, Safety and CMO, Merck, Darmstadt, Germany
| | | | - Harshal Chaudhari
- Biopharma, NDD and Endocrinology, Merck Specialties Pvt. Ltd., Mumbai, India
- *Harshal Chaudhari:
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25
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Kim SJ, Kwak HH, Cho SY, Sohn YB, Park SW, Huh R, Kim J, Ko AR, Jin DK. Pharmacokinetics, Pharmacodynamics, and Efficacy of a Novel Long-Acting Human Growth Hormone: Fc Fusion Protein. Mol Pharm 2015; 12:3759-65. [DOI: 10.1021/acs.molpharmaceut.5b00550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Su Jin Kim
- Department
of Pediatrics, Myongji Hospital, Seonam University College of Medicine, Goyang, Republic of Korea
| | - Hyun-Hee Kwak
- Biopharmaceutical
Research Laboratoy, Dong-A Socio Holdings Research Institute, Gyeonggi, Republic of Korea
| | - Sung Yoon Cho
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Bae Sohn
- Department
of Medical Genetics, Ajou University Hospital, Suwon, Republic of Korea
| | - Sung Won Park
- Department
of Pediatrics, Jeil Hospital, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Rimm Huh
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jinsup Kim
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ah-ra Ko
- Clinical
Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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