Background: Endogenous GH secretion physiologically increases during puberty. In particular, a correlation between GH levels and pubertal stages can be stated. Therefore, it is possible that some patients with childhood-onset GH deficiency (GHD) at puberty normalize their GH secretion. Finally, there are not so far assessed potential predictors of persistent GHD in patients during puberty.
Objective and hypotheses: Our study aims evaluating the normalisation of GH secretion during puberty in a cohort of GHD adolescents. Secondly, we intend to verify if it is possible to pinpoint some factors which may predict the GH sufficiency at puberty.
Method: We enrolled 72 patients (40 boys, 32 girls) with history of childhood-onset GHD who had received >1 year of GH treatment and had reached the pubertal Tanner stage 3. All of them were submitted to arginine re-test to evaluate the GH secretion. Auxological and hormonal data at diagnosis and at reevaluation of GH secretion were analysed.
Results: At retesting, 42 subjects (58.3%) normalized GH secretion and 30 subjects (41.7%) confirmed a GHD. No predictive factors of GH sufficiency were identified. In particular, IGF1 levels were no significantly different in both groups. Interestingly, at the puberty onset the adolescents with sufficient GH secretion decelerate their growth velocity, whereas the GHD adolescents maintain their regular and progressive growth. Finally, the adolescents that normalized their GH secretion showed a BMI significant lower (18.75 kg/m2) than GHD patients (20.58 kg/m2).
Conclusion: The majority of childhood-onset GHD patients acquires a sufficient GH secretion at puberty. Although no predictive factors of GH sufficiency are emerged, to retest GH secretion during puberty may be recommended, in particular in cases of GHD adolescents with a mild GHD at diagnosis.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology