Effect of growth hormone therapy on thyroid function in isolated growth hormone deficient and short small for gestational age children: a two-year study, including on assessment of the usefulness of the thyrotropin-releasing hormone (TRH) stimulation test
-
Yuki Ebuchi
,
Toshihide Kubo
Abstract
Background
The relationship between growth hormone (GH)-replacement therapy and the thyroid axis in GH-deficient (GHD) children remains controversial. Furthermore, there have been few reports regarding non-GHD children. We aimed to determine the effect of GH therapy on thyroid function in GHD and non-GHD children and to assess whether thyrotropin-releasing hormone (TRH) stimulation test is helpful for the identification of central hypothyroidism before GH therapy.
Methods
We retrospectively analyzed data from patients that started GH therapy between 2005 and 2015. The free thyroxine (FT4) and thyroid-stimulating hormone (TSH) concentrations were measured before and during 24 months of GH therapy. The participants were 149 children appropriate for gestational age with GHD (IGHD: isolated GHD) (group 1), 29 small for gestational age (SGA) children with GHD (group 2), and 25 short SGA children (group 3).
Results
In groups 1 and 2, but not in group 3, serum FT4 concentration transiently decreased. Two IGHD participants exhibited central hypothyroidism during GH therapy, and required levothyroxine (LT4) replacement. They showed either delayed and/or prolonged responses to TRH stimulation tests before start of GH therapy.
Conclusions
GH therapy had little pharmacological effect on thyroid function, similar changes in serum FT4 concentrations were not observed in participants with SGA but not GHD cases who were administered GH at a pharmacological dose. However, two IGHD participants showed central hypothyroidism and needed LT4 replacement therapy during GH therapy. TRH stimulation test before GH therapy could identify such patients and provoke careful follow-up evaluation of serum FT4 and TSH concentrations.
Acknowledgments
We thank Charles Allan, PhD, and Mark Cleasby, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
Research funding: None declared.
Author contributions: All authors conceived the study concept and study design. Yuki Ebuchi drafted the manuscript. Shoko Fujinaga, Hiroki Tsuchiya, Naoko Urata, Motoharu Ochi, Takahiro Namba, Narumi Hara, Michiko Kishi, contributed to acquisition of data for the work. Mahoko Furujo and Yousuke Higuchi contributed to revise manuscript critically for important intellectual content. Toshihide Kubo supervised the research project. All authors participated in interpretation of the results and writing of the report and approved the final version.
Competing interests: Authors state no conflict of interest.
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- The influence of growth hormone therapy on the cardiovascular system in Turner syndrome
- Original Articles
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- Clinical relevance of T lymphocyte subsets in pediatric Graves’ disease
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- Pubertal development and adult height in patients with congenital hypothyroidism detected by neonatal screening in southern Brazil
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- BRAFV600E and TERT promoter mutations in paediatric and young adult papillary thyroid cancer and clinicopathological correlation
- Case Reports
- Pseudohypoparathyroidism type 1B (PHP1B), a rare disorder encountered in adolescence
- Impaired glucose homeostasis and a novel HLCS pathogenic variant in holocarboxylase synthetase deficiency: a report of two cases and brief review
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Articles in the same Issue
- Frontmatter
- Review Article
- The influence of growth hormone therapy on the cardiovascular system in Turner syndrome
- Original Articles
- Clinical utility of urinary gonadotrophins in hypergonadotrophic states as Turner syndrome
- Sclerostin and osteoprotegerin: new markers of chronic kidney disease mediated mineral and bone disease in children
- Monthly intravenous alendronate treatment can maintain bone strength in osteogenesis imperfecta patients following cyclical pamidronate treatment
- Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes
- Frequency of thyroid dysfunction in pediatric patients with congenital heart disease exposed to iodinated contrast media – a long-term observational study
- Effect of growth hormone therapy on thyroid function in isolated growth hormone deficient and short small for gestational age children: a two-year study, including on assessment of the usefulness of the thyrotropin-releasing hormone (TRH) stimulation test
- Clinical relevance of T lymphocyte subsets in pediatric Graves’ disease
- Long-term follow-up of differentiated thyroid carcinoma in children and adolescents
- A quality improvement project for managing hypocalcemia after pediatric total thyroidectomy
- Pubertal development and adult height in patients with congenital hypothyroidism detected by neonatal screening in southern Brazil
- Clinical characteristics, surgical approach, BRAFV600E mutation and sodium iodine symporter expression in pediatric patients with thyroid carcinoma
- BRAFV600E and TERT promoter mutations in paediatric and young adult papillary thyroid cancer and clinicopathological correlation
- Case Reports
- Pseudohypoparathyroidism type 1B (PHP1B), a rare disorder encountered in adolescence
- Impaired glucose homeostasis and a novel HLCS pathogenic variant in holocarboxylase synthetase deficiency: a report of two cases and brief review
- Transcobalamin II deficiency in twins with a novel variant in the TCN2 gene: case report and review of literature
- Aldosterone deficiency with a hormone profile mimicking pseudohypoaldosteronism
- Non-classical lipoid adrenal hyperplasia presenting as hypoglycemic seizures
