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Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height

  • Marilza de Jesus Modesto , Nadia Mohamad Amer , Oscar Erichsen , Sara Hernandez , Cláudia Duarte dos Santos , Julienne Ângela Ramires de Carvalho , Rosana Marques Pereira , Suzana Nesi França and Luiz De Lacerda EMAIL logo
Published/Copyright: April 21, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 9-10

Abstract

We assessed body composition and muscle strength during the transition phase in 18 growth hormone (GH) deficient males treated with recombinant GH to final height and 18 controls. According to peak-stimulated GH and basal insulin-like growth factor-1 (IGF-1) during the transition phase, patients were subdivided into GH deficient (GHD-TP, n=9) and GH sufficient (GHS-TP, n=9) groups. Assessments included lean and fat body mass and bone mineral density (BMD), all measured by dual-energy X-ray absorptiometry, and dynamic knee muscle strength, assessed by isokinetic dynamometer. Total body and lumbar spine BMD and muscle strength were lower in GHD-TP patients when compared with GHS-TP and controls (all p<0.05), whereas lean and fat body mass were lower in both GHD-TP and GHS-TP patients when compared with controls (p<0.05). These findings suggest that administration of recombinant GH to final height is not sufficient to provide normal body composition and muscle strength in young male patients with GH deficiency.

Keywords: body composition; growth hormone deficiency; muscle strength; recombinant growth hormone; transition phase
Corresponding author: Luiz De Lacerda, Pediatric Endocrinologist, Endocrinology Pediatric Unit (UEP) at HC-UFPR, Curitiba, Paraná, Brazil, Phone/Fax: +55 41 35244747, E-mail: ; and Rua Padre Camargo, 250. CEP 80060-240, Curitiba, Paraná, Brazil

References

1. Clayton PE, Cuneo R, Juul A, Monson JP, Shalet SM, et al. Consensus statement on management of the GH treated adolescent in the transition to adult care. Eur J Endocrinol 2005;152:165–70.10.1530/eje.1.01829Search in Google Scholar

2. Shalet SM, Shavrikova E, Cromer M, Child CJ, Keller E, et al. Effect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2 year randomized, controlled, dose-ranging study. J Clin Endocrinol Metab 2003;88:4124–9.10.1210/jc.2003-030126Search in Google Scholar

3. Melmed S, Kleinberg D, Ho K. Pituitary physiology and diagnostic evaluation. In: Williams textbook of endocrinology, 12th ed. Philadephia: Elsevier Saunders, 2011:175–228.Search in Google Scholar

4. Rooyakers OE, Nair KS. Hormonal regulation of human muscle protein metabolism. Ann Rev Nutr 1997;17:457–85.10.1146/annurev.nutr.17.1.457Search in Google Scholar

5. Johannsson G, Albertsson-Wikland K, Bengtsson B. Discontinuation of growth hormone (GH) treatment: metabolic effects in GH-deficient and GH-sufficient adolescent patients compared with control subjects. J Clin Endocrinol Metab 1999;84:4516–24.10.1210/jc.84.12.4516Search in Google Scholar

6. Cutfield WS, Wilton P, Bennmarker H, Albertsson-Wikland K, Chatelain P, et al. Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth hormone treatment. Lancet 2000;355:610–3.10.1016/S0140-6736(99)04055-6Search in Google Scholar

7. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1587–609.10.1210/jc.2011-0179Search in Google Scholar

8. Jørgensen JO, Pedersen SA, Thuesen L, Jørgensen J, Ingemann-Hansen T, et al. Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet 1989;1:1221–4.10.1016/S0140-6736(89)92328-3Search in Google Scholar

9. Rutherford OM, Jones DA, Round JM, Preece MA. Changes in skeletal muscle after discontinuation of growth hormone treatment in young adults with hypopituitarism. Acta Paediatr Scand 1989;356:61–3.10.1111/j.1651-2227.1989.tb11244.xSearch in Google Scholar PubMed

10. Hulthén L, Bengtsson BA, Sunnerhagen KS, Leif Hallberg L, Grimby G, et al. GH is needed for the maturation of muscle mass and strength in adolescents. J Clin Endocrinol Metab 2001;86:4765–70.10.1210/jcem.86.10.7897Search in Google Scholar PubMed

11. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. Stanford, California: Stanford University Press, 1959.10.1097/00000441-195909000-00030Search in Google Scholar

12. Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. Part I. Arch Dis Child 1996;41:454–71.10.1136/adc.41.219.454Search in Google Scholar PubMed PubMed Central

13. Growth Hormone Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. J Clin Endocrinol Metab 2000;85:3990–3.Search in Google Scholar

14. Elmlinger MW, Kühnel W, Weber MM, Ranke MB. Reference ranges for two automated chemiluminescent assays for serum insulin-like growth factor I (IGF-1) and IGF-binding protein 3 (IGFBP-3). Clin Chem Lab Med 2004;42:654–64.10.1515/CCLM.2004.112Search in Google Scholar PubMed

15. Baim S, Binkley N, Bilezikian JP, Kendler DL, Hans DB, et al. Official positions of the International Society for Clinical Densitometry and executive summary of the 2007 position development conference. J Clin Densitom 2008;11:75–91.10.1016/j.jocd.2007.12.007Search in Google Scholar PubMed

16. Siqueira CM, Pelegrini FR, Fontana MF, Greve JM. Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes. Rev Hosp Clin Fac Med, São Paulo 2002;57:19–24.10.1590/S0041-87812002000100004Search in Google Scholar PubMed

17. Spina LDC, Soares DV, Brasil RRLO, Lobo PM, Conceição FL, et al. Glucose metabolism and visceral fat in GH deficient adults: Two years of GH-replacement. Pituitary 2004:7;123–129.10.1007/s11102-005-5065-6Search in Google Scholar PubMed

18. De Boer H, Blok GJ, Voerman HJ, De Vries PM, van der Veen EA. Body composition in adult growth deficient men assessed by anthropometry and bioimpedance analysis. Clin Endocrinol Metab 1992;75:833–7.Search in Google Scholar

19. Bengtsson BA, Edén S, Lönn L, Kvist H, Stokland A, et al. Treatment of adults with growth hormone deficiency with recombinant human GH. J Clin Endocrinol Metab 1993;76:309–17.Search in Google Scholar

20. Salomon F, Cuneo RC, Hesp R, Sönksen PH. The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. N Engl J Med 1989;321:1797–803.10.1056/NEJM198912283212605Search in Google Scholar PubMed

21. Holmes SJ, Whitehouse RW, Swindell R, Economou G, Adams JE, et al. Effect of growth hormone replacement on bone mass in adults with adult onset growth hormone deficiency. Clin Endocrinol 1995;42:627–33.10.1111/j.1365-2265.1995.tb02690.xSearch in Google Scholar PubMed

22. De Boer H, Block GJ, Van Lingen A, Teule GJ, Lips P, et al. Consequences of childhood-onset growth hormone deficiency for adult bone mass. J Bone Miner Res 1994;9:1319–26.10.1002/jbmr.5650090822Search in Google Scholar PubMed

23. Kaufamn JM, Taelman P, Vermeulen A, Vandeweghe M. Bone mineral status in growth-hormone deficient males with isolated and multiple pituitary deficiencies of childhood onset. J Clin Endocrinol Metab 1992;74:118–23.Search in Google Scholar

24. Yarasheski KE. Growth hormone effects on metabolism, body composition, muscle mass, and strength. In: Holloszy JO, editor. Exercise and Sport Sciences Review. Baltimore: Williams and Wilkins, 1994:285–312.Search in Google Scholar

25. Isgaard J, Nilsson A, Ohlsson C, Lindahl A, Wahlander H, Friberg P, Isaksson O. Tissue Expression of Insulin-like Growth Factor I. In: Müller EE, Chocchi D, Locatelli V, editors. Growth hormone and somatomedins during lifespan. Berlin: Springer-Verlag Berlin Heidelberg, 1993:65–70.Search in Google Scholar

26. Webb SM, de Andrés-Aguayo I, Rojas-García R, Ortega E, Gallardo E, et al. Neuromuscular dysfunction in adult growth hormone deficiency. Clin Endocrinol 2003;59:450–8.10.1046/j.1365-2265.2003.01866.xSearch in Google Scholar PubMed

27. Cuneo RC, Salomon F, Wiles CM, Sonksen PH. Skeletal muscle performance in adults with growth hormone deficiency. Horm Res 1990;33:55–60.10.1159/000181585Search in Google Scholar PubMed

28. De Boer H, Van Der Veen EA. Why retest young adults with childhood-onset growth hormone deficiency? J Clin Endocrinol Metab 1997;82:2032–6.10.1210/jcem.82.7.4101Search in Google Scholar PubMed

29. Beunen G, Malina RM. Growth and physical performance relative to the timing of the adolescent spurt. Exer Sport Sci Re 1988;16:502–40.10.1249/00003677-198800160-00018Search in Google Scholar

30. Gibney J, Wallace JD, Spinks T, Schnorr L, Ranicar A, et al. The effects of 10 years of recombinant human growth hormone (GH) in adult GH-deficient patients. J Clin Endocrinol Metab 1999;84:2596–602.10.1210/jcem.84.8.5916Search in Google Scholar PubMed

31. Janssen YJH, Doornbos J, Roelfsema F. Changes in muscle volume, strength and bioenergetics during recombinant human growth hormone (GH) therapy in adults with GH deficiency. J Clin Endocrinol Metab 1999;84:279–84.10.1210/jc.84.1.279Search in Google Scholar

32. Rutherford OM, Beshyah SA, Schott J, Watkins Y, Johnston DG. Contractile properties of the quadriceps muscle in growth hormone-deficient hypopituitary adults. Clin Sci 1995;88: 67–71.10.1042/cs0880067Search in Google Scholar PubMed

33. Garry P, Collins P, Devlin JG. An open 36 month study of lipid changes with growth hormone in adults: lipid changes following replacement of growth hormone in adult acquired growth hormone deficiency. Eur J Endocrinol 1996;134:61–6.10.1530/eje.0.1340061Search in Google Scholar PubMed

34. Koranyi J, Svensson J, Götherström G, Sunnerhagen KS, Bengtsson B, et al. Baseline characteristics and the effects of five years of growth hormone (GH) replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study. J Clin Endocrinol Metab 2001;86:4693–9.10.1210/jcem.86.10.7896Search in Google Scholar PubMed

35. Adamo M, Lowe WL Jr, Leroith D, Roberts CT Jr. Insulin-like growth factor I messenger ribonucleic acids with alternative 5’-untranslated regions are differentially expressed during development of the rat. Endocrinology 1989;124:2737–44.10.1210/endo-124-6-2737Search in Google Scholar PubMed

36. Jennischen E, Anderson G. Expression of GH receptor mRNA in regenerating skeletal muscle of normal and hypophysectomized rats. An in situ hybridization study. Acta Endocrinol 1991;125:595–602.Search in Google Scholar

Received: 2013-8-1
Accepted: 2014-3-24
Published Online: 2014-4-21
Published in Print: 2014-9-20

©2014 by De Gruyter

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  1. Frontmatter
  2. Review article
  3. Towards an optimization of the management of endocrine complications of thalassemia
  4. Original articles
  5. The natural course of Hashimoto’s thyroiditis in children and adolescents
  6. Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height
  7. Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features
  8. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
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  19. The evaluation of thyroid carcinoma in childhood and concomitance of autoimmune thyroid disorders
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  22. Management of central diabetes insipidus with oral desmopressin lyophilisate in infants
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  34. Berardinelli-Seip congenital lipodystrophy: an autosomal recessive disorder with rare association of duodenocolonic polyps
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  36. Ovarian hyperstimulation syndrome treated by medroxyprogesterone acetate
  37. Symptomatic cerebral infarction in a child with severe diabetic ketoacidosis
  38. A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease
  39. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: is there an association? A case report and literature review
  40. Cholestasis and protein-losing enteropathy secondary to hyperthyroidism in a 6-year-old girl
  41. Short communication
  42. An essential splice site mutation (c.317+1G>A) in the TSHR gene leads to severe thyroid dysgenesis
  43. Letter to the Editor
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https://doi.org/10.1515/jpem-2013-0317
Keywords for this article
body composition; growth hormone deficiency; muscle strength; recombinant growth hormone; transition phase

Articles in the same Issue

  1. Frontmatter
  2. Review article
  3. Towards an optimization of the management of endocrine complications of thalassemia
  4. Original articles
  5. The natural course of Hashimoto’s thyroiditis in children and adolescents
  6. Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height
  7. Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features
  8. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
  9. Counseling patients with succinate dehydrogenase subunit defects: genetics, preventive guidelines, and dealing with uncertainty
  10. Pubertal development profile in patients with Turner syndrome
  11. A novel CASR mutation associated with neonatal severe hyperparathyroidism transmitted as an autosomal recessive disorder
  12. Serum insulin-like growth factor-binding protein-3 level correlated with glycemic control and lipid profiles in children and adolescents with type 1 diabetes
  13. Adult human liver mesenchymal progenitor cells express phenylalanine hydroxylase
  14. Clinical applicability of rapid detection of SRY and DYS14 genes in patients with disorders of sex development using an indigenously developed 5′ exonuclease based assay
  15. Hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia in four Egyptian families: report of three novel mutations in the vitamin D receptor gene
  16. Permanent neonatal diabetes mellitus in Jordan
  17. The effect of adenotonsilectomy on ghrelin, leptin, IGF-1 levels and growth parameters in children with adenotonsillar hypertrophy
  18. The role of anti-Mullerian and inhibin B hormones in the evaluation of 46,XY disorders of sex development
  19. The evaluation of thyroid carcinoma in childhood and concomitance of autoimmune thyroid disorders
  20. Lipid patterns in treated growth hormone deficient children vs. short stature controls
  21. Assessment of aortic morphology and compliance in children and adolescents with Ullrich-Turner syndrome (UTS) using magnetic resonance imaging (MRI)
  22. Management of central diabetes insipidus with oral desmopressin lyophilisate in infants
  23. Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone
  24. Patient reports
  25. A rare case of pituitary infarction leading to spontaneous tumour resolution and CSF-sella syndrome in an 11-year-old girl and a review of the paediatric literature
  26. Rare case of homozygous epimerase deficiency and heterozygous of duarte 2 variant
  27. Persistent congenital hyperinsulinism in two patients with Beckwith-Wiedemann syndrome due to mosaic uniparental disomy 11p
  28. Growth hormone treatment in a patient with Hurler-Scheie syndrome
  29. Neonatal diagnosis of a patient with hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome associated with cerebral infarction
  30. Early-onset diabetes mellitus and neurodevelopmental retardation: the first Greek case of Wolcott-Rallison syndrome
  31. Type III Bartter-like syndrome in an infant boy with Gitelman syndrome and autosomal dominant familial neurohypophyseal diabetes insipidus
  32. Cushing’s syndrome: hidden risk in usage of topical corticosteroids
  33. Prader-Willi syndrome: a case report with atypical developmental features
  34. Berardinelli-Seip congenital lipodystrophy: an autosomal recessive disorder with rare association of duodenocolonic polyps
  35. Ectopic Cushing syndrome secondary to metastatic medullary thyroid cancer in a child with multiple endocrine neoplasia syndrome type 2B: clues to early diagnosis of the paraneoplastic syndromes
  36. Ovarian hyperstimulation syndrome treated by medroxyprogesterone acetate
  37. Symptomatic cerebral infarction in a child with severe diabetic ketoacidosis
  38. A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease
  39. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: is there an association? A case report and literature review
  40. Cholestasis and protein-losing enteropathy secondary to hyperthyroidism in a 6-year-old girl
  41. Short communication
  42. An essential splice site mutation (c.317+1G>A) in the TSHR gene leads to severe thyroid dysgenesis
  43. Letter to the Editor
  44. Pubertal gynecomastia: what about the remaining 10%?
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