Exploring the Impact of Growth Hormone Therapy on Glucose and Insulin Metabolism in Children with GH Deficiency: A Review

Ashraf Soliman; Fawzia Alyafei; Nada Alaaraj; Noor Hamed; Shayma Ahmed

Introduction: Children with growth hormone (GHD) often exhibit unique patterns in glucose and insulin metabolism, which could potentially deteriorate upon receiving GH therapy. This therapeutic intervention, while crucial for promoting normal growth, may inadvertently influence the intricate balance of glucose homeostasis and insulin sensitivity,

Methods: We reviewed and analyzed 12 studies based on their relevance, in children with GHD treated with GH, and outcomes related to glucose and insulin parameters to assess temporal trends in research findings.

Results: Studies are summarized in the table:


Author(s)	Year	Main Findings	Number of Children Studied
J. Walker et al.	1989	GH therapy in non-GH-deficient children did not impair glucose tolerance, with consistent insulin and C-peptide concentration increases.	10
A M Rosenfalck et al.	2000	GH-replacement therapy induced deterioration in glucose tolerance, significant changes in insulin and C-peptide kinetics.	11
P. Saenger	2000	GH therapy showed no significant diabetogenic effects during a 1-yr treatment period in non-GH-deficient short stature children.	Not specified
Claudia Giavoli et al.	2004	Worsening of insulin sensitivity short-term; long-term benefits on body composition.	20
G. Radetti et al.	2004	GH therapy influenced insulin sensitivity in GH-deficient children, indicating a need for careful monitoring to prevent glucose intolerance.	Not specified
Li Liang et al.	2006	Increased risk of insulin resistance and transient glucose metabolic disorder in some patients.	44
Nicole Wooten et al.	2008	Lower abdominal adiposity and improved glucose tolerance in GH-treated girls.	102
Ellen M N Bannink et al.	2009	GH therapy has additional beneficial effects on serum lipids; GH-induced decrease in insulin sensitivity remained unchanged.	39
Christopher J Child et al.	2011	Increased incidence of type 2 diabetes in GH-treated children compared to the general population.	11,686
Amélie Poidvin et al.	2017	No difference in the risk of diabetes between GH-treated patients and the reference population.	5,100
Federico Baronio et al.	2017	No negative influence of GH treatment on insulin sensitivity and β-cell secretory capacity in girls with TS.	104
M Lutski et al.	2019	No diabetes prevalence difference in isolated GHD and SGA vs. general population; increased diabetes in children with pre-existing risk factors.	2,513

Discussion: The studies reveal both the therapeutic benefits of GH therapy and its potential metabolic risks, showing a complex relationship between GH treatment and glucose metabolism.

Conclusion: GH treatment in children requires careful consideration of both its growth-promoting effects and potential metabolic impacts, necessitating personalized approaches based on individual risk factors.

ESPE Abstracts

P3-129