Background: GH deficiency (GHD) in adults has been consistently associated with increased adiposity and decreased lean mass. Data in childhood are still scanty and the most appropriate tools to assess body composition in these children remain to be established.
Objective and hypotheses: To evaluate the effects of GHD and GH replacement therapy (GHRT) on body composition in GHD children and make a comparison between DXA and anthropometric measures in evaluating adiposity in these patients.
Method: Twenty prepubertal children (10.36±3.58 years) with GHD were evaluated before and after 2 years of GHRT. Patients underwent measurement of height, weight, BMI, waist circumference (WC), hip circumference, waist to hip (WHR), and waist to height ratio (WHtR). DXA analysis was performed to evaluate fat mass percentage (FM%) and lean mass percentage (LM%). Anthropometric measures were also evaluated in 20 healthy children, comparable for age, sex, and height with the patients.
Results: At baseline WHtR was significantly higher in GHD children (0.49±0.05 vs 0.44±0.03, P<0.01), whereas no differences were found in BMI, WC, hip circumference, and WHR. GHRT was associated with a significant reduction in WHtR (0.45±0.03, P<0.01). Furthermore, GHRT was associated with a reduction in FM% (27.57±7.46% vs 22.15±6.49, P<0.0001) and an increase in LM% (68.62±7.13 vs 74.62±6.55, P<0.0001). Correlation studies revealed that WHtR significantly correlated with FM% and LM% evaluated by DXA at study entry (r=0.61, P<0.01; r=−0.60, P<0.001 respectively) and after GHRT (r=0.61, P<0.05; r=−0.58, P<0.05 respectively), whereas no correlations were found between DXA measurements and other parametric indices.
Conclusion: Untreated GHD in children is associated with increased abdominal adiposity in comparison to healthy, matched controls. GHRT improves body composition increasing lean mass and decreasing fat mass.
In our study the evaluation of WHtR yielded to results comparable to DXA measurements thus leading to conclude that WHtR may represent a simple clinical tool which accurately reflects fat distribution.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology