ESPE Abstracts (2014) 82 P-D-2-2-306

Effects of Recombinant Human GH on Bone Mass and Body Composition in Paediatric Inflammatory Bowel Disease

M A Altowatia, S Shepherda, P McGroganb, R K Russellb, S F Ahmeda & S C Wonga


aDevelopmental Endocrinology Research Group, Royal Hospital for Sick Children, University of Glasgow, Glasgow, UK; bDepartment of Gastroenterology, Royal Hospital for Sick Children, Glasgow, UK


Background: rhGH therapy may improve linear growth in children with inflammatory bowel disease (IBD). Poor bone health and abnormal body composition are recognised complications in paediatric IBD.

Objective and hypotheses: To investigate the effects of rhGH on bone health and body composition.

Method: Sub-analysis of 13 children with IBD (12CD; 1UC) in a randomized controlled trial. Either rhGH (0.067 mg/kg per day) as daily s.c. injections (rhGH group; n, 7CD) or no rhGH (Ctrl; n, 5CD 1UC) for 6 months. Results expressed in median (range).

Results: In the rhGH group, BMC for bone area (BA) SDS was 0.0 (−0.5, 0.5) at the baseline and −0.2 (−0.7, 0.5) (P=0.5) at 6 months and in the Ctrl group it was 0.0 (−0.1, 1) and −0.05 (−0.3, 0.7) (P=0.3). Median P1NP increased from 169 μg/l (21 250) at baseline to 241 μg/l (238 250) at 6 months (P=0.06) in the rhGH group, whereas in the Ctrl group, it was 199.5 μg/l (155 218) and 211.5 μg/l (162 231) respectively (P=0.30). There were no significant changes in urinary CTX after 6 months in the rhGH and Ctrl group. In the rhGH group, DXA lean mass for height centiles changed from 43 (0.0, 97) at base line to 47 (7, 56) at 6 months (P=0.9) and in the Ctrl group it was 13.5 (0.0, 26) and 10.5 (0.0, 29) (P=0.3) respectively. DXA percentage fat mass in rhGH group was 26.3% (15.1, 30.3) at baseline and 20.8% (8.6, 29.1) (P=0.2) at 6 months and in the Ctrl group it was 24.6% (16.7, 36.1) and 26.6% (16.8, 39.2) (P=0.1). Leptin was 3.7 ng/ml (0.4, 4.2) in the rhGH group at baseline and 1.7 ng/ml (0.4, 11.8) (P=0.8) at 6 months, whereas this was 3.3 ng/ml (0.8, 11.7) and 2.8 ng/ml (0.6, 116.6) (P=0.6) in the Ctrl group. Similarly, adiponectin was 15 712 ng/ml (10 675, 25 000) in the rhGH group at baseline and 19 072 ng/ml (6512, 25 000) (P=0.8) at 6 months, whereas this was 14 923 ng/ml (8778, 15 820) and 15 429 ng/ml (9151, 20 459) (P=0.5) in the Ctrl group.

Conclusion: Over a 6-month period of high-dose rhGH, there are no significant changes in bone mass and body composition in paediatric IBD despite some evidence of an increase in a marker of bone formation.

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