Benefits and risks evaluation of recombinant human growth hormone replacement therapy in children with GHD after craniopharyngioma surgery

Li-li Pei; Ying Guo; Han Chen; Li-Yong Zhong

doi:10.1515/jpem-2022-0605

Article

Benefits and risks evaluation of recombinant human growth hormone replacement therapy in children with GHD after craniopharyngioma surgery

Li-li Pei , Ying Guo , Han Chen and Li-Yong Zhong

Published/Copyright: March 21, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 5

Abstract

Objectives

Childhood-onset craniopharyngiomas (CPs) have a high incidence of growth hormone deficiency (GHD) leading to growth failure and metabolic disorders. We aim to evaluate the benefits and risks of recombinant human growth hormone replacement therapy (GHRT) in postoperative children.

Methods

We retrospectively analyzed auxological and metabolic parameters and adverse events before and after GHRT of 44 children after CP surgery.

Results

The median duration of GHRT was 24 months (IQR, 12.5–36). Growth velocity (GV) increased significantly after different treatment duration (TD) compared with baseline (p<0.001) and attained the greatest GV of 12.06 ± 4.16 cm/year at TD6. The mean height standard deviation score (HtSDS) from −3.20 ± 1.16 at baseline improved significantly to −1.51 ± 1.32 at TD36 (p<0.001). There were significant increases in insulin-like growth factor-1 SDS (IGF-1SDS), insulin-like growth factor binding protein 3 SDS (IGFBP-3SDS), bone age (BA), and BA/chronological age (CA) (p<0.05). There was a significant reduction in waist-to-hip ratio (WHR), but there were no significant changes in weight SDS (WtSDS) or BMISDS. Low-density lipoprotein-cholesterol (LDL-C) levels and the incidence of hypercholesterolemia decreased (p<0.05). Three patients (6.8%) had tumor recurrence after 15, 30, and 42 months, respectively. A patient had residual tumor enlargement after 3 months. There was no adverse influence on glucose metabolism or any severe adverse events.

Conclusions

GHRT effectively accelerates GV, increases HtSDS, and improves lipid profiles without unfavorable effects on glucose metabolism. The benefits are clear and the risks of adverse events are low.

Keywords: children; craniopharyngioma; growth hormone deficiency; human growth hormone

Corresponding author: Prof. Li-Yong Zhong, Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring Road West, Fengtai District, Beijing 100070, China, Phone: +086-010-59976618, E-mail: zhongliyong@bjtth.org

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Data analysis was performed retrospectively, with all procedures and analyses approved by the local ethics committee according to the Declaration of Helsiniki (IRB of Beijing Tiantan Hospital, Capital Medical University, KY2022-024-01).

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Received: 2022-11-28

Accepted: 2023-02-23

Published Online: 2023-03-21

Published in Print: 2023-05-25

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Articles in the same Issue

https://doi.org/10.1515/jpem-2022-0605

Keywords for this article

children; craniopharyngioma; growth hormone deficiency; human growth hormone