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Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents

  • Juliane Rothermel EMAIL logo , Nina Lass , Christina Bosse and Thomas Reinehr
Published/Copyright: June 24, 2017
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 30 Issue 7

Abstract

Background:

While the main role of growth hormone (GH) replacement therapy in children is to promote linear growth, GH has also an effect on lipids and body composition. There is an ongoing discussion whether discontinuation of GH treatment is associated with deterioration of lipids.

Methods:

We analyzed weight status [as body mass index-standard deviation score (BMI-SDS)], insulin like growth factor (IGF)-1, triglycerides, total, low-density liporptoein (LDL)- and high-density lipoprotein (HDL)-cholesterol at the end of GH treatment and in mean 6 months later in 90 adolescents (53 with GH deficiency, 16 with Turner syndrome [TS] and 21 born small-for-gestational age [SGA]).

Results:

After stopping GH treatment, total cholesterol (+10±24 mg/dL vs. −4±13 mg/dL) and LDL-cholesterol (+15±20 mg/dL vs. −6±12 mg/dL) increased significantly higher in severe (defined by GH peak in stimulation test <3 ng/mL) compared to moderate GHD. In patients with TS, total cholesterol (+19±9 mg/dL), LDL-cholesterol (+9±12 mg/dL) and HDL-cholesterol (+4.3±3.5 mg/dL) increased significantly. In adolescents born SGA, triglycerides increased (+34±51 mg/dL) and HDL-cholesterol decreased significantly (−3.8±7.1 mg/dL). In multiple linear regression analyses, changes of total and LDL-cholesterol were significantly negatively related to peak GH in stimulation tests, but not to gender, age at GH start, duration of GH treatment, observation time, changes of BMI-SDS or IGF-1 after the end of GH treatment. The BMI-SDS did not change after the end of GH treatment.

Conclusions:

Discontinuation of GH treatment leads to a deterioration of lipids in TS, SGA and severe but not moderate GHD.

Keywords: body weight; discontinuation; growth hormone; lipids
Corresponding author: Prof. Dr. Thomas Reinehr, Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Dr. F. Steiner Str. 5, 45711 Datteln, Germany, Phone: +49-2363-975-229, Fax: +49-2363-975-218

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This work was supported by a grant from Sandoz, Novartis. Study design, data collection and analysis, decision to publish, and preparation of the manuscript are solely the responsibility of the authors.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: https://doi.org/10.1515/jpem-2017-0098) offers supplementary material, available to authorized users.

Received: 2017-3-6
Accepted: 2017-6-2
Published Online: 2017-6-24
Published in Print: 2017-7-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpem-2017-0098
Keywords for this article
body weight; discontinuation; growth hormone; lipids

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
  4. Improved metabolic control in tetrahydrobiopterin (BH4), responsive phenylketonuria with sapropterin administered in two divided doses vs. a single daily dose
  5. Excessive weight gain in exclusively breast-fed infants
  6. Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
  7. Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study
  8. Assessment of insulin like growth factor-1 and IGF binding protein-3 in healthy Indian girls from Delhi and their correlation with age, pubertal status, obesity and thyroid hormonal status
  9. Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents
  10. Clinical, biochemical and genetic features with nonclassical 21-hydroxylase deficiency and final height
  11. A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
  12. Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
  13. Case Reports
  14. Pediatric toxic polycystic thyroid
  15. In utero virilization secondary to a maternal Krukenberg tumor: case report and review of literature
  16. Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
  17. Long-term follow-up of a child with Klinefelter syndrome and achondroplasia from infancy to 16 years
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