Mapping the journey of transition: a single-center study of 170 childhood-onset GH deficiency patients
Objective To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP). Design Single- center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2 ± 2.0 years, rang...
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| Vydané v: | Endocrine Connections Ročník 10; číslo 8; s. 935 - 946 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , |
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Bristol
Bioscientifica Ltd
01.08.2021
Bioscientifica |
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| ISSN: | 2049-3614, 2049-3614 |
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| Abstract | Objective To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP). Design Single- center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2 ± 2.0 years, range 16–25) transferred after growth completion from two pediatric clinics to the adult endocrine unit. Two separate analyses were performed: (i) cross-sectional analysis of hormonal status, metabolic parameters, BC, and BMD at first evaluation after transfer from pediatrics to the adult department; (ii) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP. Results COGHD was of a congenital cause (CONG) in 50.6% subjects, tumor-related (TUMC) in 23.5%, and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (P < 0.01) and lower Z score at L-spine (P < 0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrated lower fat mass and increased BMD compared to the rhGH-untreated group (P < 0.01). Three years of rhGH after growth completion resulted in a significant increase in lean body mass (12.1%) and BMD at L-spine (6.9%), parallel with a decrease in FM (5.2%). Conclusion The effect of rhGH in childhood is invaluable for metabolic status, BC, and BMD in transition to adulthood. Tumor-related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition, and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BC and BMD in patients with persistent COGHD. |
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| AbstractList | Objective: To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP). Design: Single- center, retrospective study was performed on 170 conse cutive COGHD patients (age 19.2 ± 2.0 years, range 16–25) transferred after growth completion from two pediatric clinics to the adult endocrine unit. Two separate analyses were performed: (i) cross-sectional analysis of hormonal status, metabolic parameters, BC, and BMD at first evaluation after transfer from pediatrics to the adult dep artment; (ii) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP. Results: COGHD was of a congenital cause (CONG) in 50.6% subjects, tumo r-related (TUMC) in 23.5%, and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (P < 0.01) and lower Z score at L-spine (P < 0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrat ed lower fat mass and increased BMD compared to the rhGH-untreated group (P < 0.01). Three years of rhGH after growth completion resulted in a significant increase in le an body mass (12.1%) and BMD at L-spine (6.9%), parallel with a decrease in FM (5.2%). Conclusion: The effect of rhGH in childhood is invaluable for metabolic sta tus, BC, and BMD in transition to adulthood. Tumor-related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition, and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BC and BMD in patients with persistent COGHD. Objective To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP). Design Single- center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2 ± 2.0 years, range 16–25) transferred after growth completion from two pediatric clinics to the adult endocrine unit. Two separate analyses were performed: (i) cross-sectional analysis of hormonal status, metabolic parameters, BC, and BMD at first evaluation after transfer from pediatrics to the adult department; (ii) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP. Results COGHD was of a congenital cause (CONG) in 50.6% subjects, tumor-related (TUMC) in 23.5%, and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (P < 0.01) and lower Z score at L-spine (P < 0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrated lower fat mass and increased BMD compared to the rhGH-untreated group (P < 0.01). Three years of rhGH after growth completion resulted in a significant increase in lean body mass (12.1%) and BMD at L-spine (6.9%), parallel with a decrease in FM (5.2%). Conclusion The effect of rhGH in childhood is invaluable for metabolic status, BC, and BMD in transition to adulthood. Tumor-related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition, and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BC and BMD in patients with persistent COGHD. To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP).OBJECTIVETo analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition period (TP).Single- center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2 ± 2.0 years, range 16-25) transferred after growth completion from two pediatric clinics to the adult endocrine unit. Two separate analyses were performed: (i) cross-sectional analysis of hormonal status, metabolic parameters, BC, and BMD at first evaluation after transfer from pediatrics to the adult department; (ii) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP.DESIGNSingle- center, retrospective study was performed on 170 consecutive COGHD patients (age 19.2 ± 2.0 years, range 16-25) transferred after growth completion from two pediatric clinics to the adult endocrine unit. Two separate analyses were performed: (i) cross-sectional analysis of hormonal status, metabolic parameters, BC, and BMD at first evaluation after transfer from pediatrics to the adult department; (ii) longitudinal analysis of BC and BMD dynamics after 3 years of GH replacement therapy (rhGH) in TP.COGHD was of a congenital cause (CONG) in 50.6% subjects, tumor-related (TUMC) in 23.5%, and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (P < 0.01) and lower Z score at L-spine (P < 0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrated lower fat mass and increased BMD compared to the rhGH-untreated group (P < 0.01). Three years of rhGH after growth completion resulted in a significant increase in lean body mass (12.1%) and BMD at L-spine (6.9%), parallel with a decrease in FM (5.2%).RESULTSCOGHD was of a congenital cause (CONG) in 50.6% subjects, tumor-related (TUMC) in 23.5%, and idiopathic (IDOP) in 25.9%. TUMC patients had increased insulin and lipids levels (P < 0.01) and lower Z score at L-spine (P < 0.05) compared to CONG and IDOP groups. Patients treated with rhGH in childhood demonstrated lower fat mass and increased BMD compared to the rhGH-untreated group (P < 0.01). Three years of rhGH after growth completion resulted in a significant increase in lean body mass (12.1%) and BMD at L-spine (6.9%), parallel with a decrease in FM (5.2%).The effect of rhGH in childhood is invaluable for metabolic status, BC, and BMD in transition to adulthood. Tumor-related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition, and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BC and BMD in patients with persistent COGHD.CONCLUSIONThe effect of rhGH in childhood is invaluable for metabolic status, BC, and BMD in transition to adulthood. Tumor-related COGHD subjects are at higher risk for metabolic abnormalities, alteration of body composition, and decreased BMD, compared to those with COGHD of other causes. Continuation of rhGH in transition is important for improving BC and BMD in patients with persistent COGHD. |
| Author | Vukovic, Rade Bogosavljevic, Vojislav Stojanovic, Marko Mitrovic, Katarina Jesic, Maja Djukic, Aleksandar Grujicic, Danica Doknic, Mirjana Zdravkovic, Vera Pekic, Sandra Milenkovic, Tatjana Milicevic, Mihajlo Savic, Dragan Petakov, Milan Soldatovic, Ivan Miljic, Dragana Manojlovic-Gacic, Emilija Todorovic, Sladjana Stanimirovic, Aleksandar |
| AuthorAffiliation | University Children’s Clinic, Belgrade, Serbia Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Institute of Medical Statistics and Informatics, Belgrade, Serbia Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Belgrade, Serbia Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia |
| AuthorAffiliation_xml | – name: Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia – name: Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia – name: Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia – name: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – name: University Children’s Clinic, Belgrade, Serbia – name: Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia – name: Faculty of Medicine, University of Belgrade, Belgrade, Serbia – name: Institute of Medical Statistics and Informatics, Belgrade, Serbia |
| Author_xml | – sequence: 1 givenname: Mirjana surname: Doknic fullname: Doknic, Mirjana email: mirjanadoknic@gmail.com organization: Faculty of Medicine, University of Belgrade, Belgrade, Serbia – sequence: 2 givenname: Marko surname: Stojanovic fullname: Stojanovic, Marko organization: Faculty of Medicine, University of Belgrade, Belgrade, Serbia – sequence: 3 givenname: Ivan surname: Soldatovic fullname: Soldatovic, Ivan organization: Institute of Medical Statistics and Informatics, Belgrade, Serbia – sequence: 4 givenname: Tatjana surname: Milenkovic fullname: Milenkovic, Tatjana organization: Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia – sequence: 5 givenname: Vera surname: Zdravkovic fullname: Zdravkovic, Vera organization: University Children’s Clinic, Belgrade, Serbia – sequence: 6 givenname: Maja surname: Jesic fullname: Jesic, Maja organization: University Children’s Clinic, Belgrade, Serbia – sequence: 7 givenname: Sladjana surname: Todorovic fullname: Todorovic, Sladjana organization: Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia – sequence: 8 givenname: Katarina surname: Mitrovic fullname: Mitrovic, Katarina organization: Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia – sequence: 9 givenname: Rade orcidid: 0000-0002-1592-4105 surname: Vukovic fullname: Vukovic, Rade organization: Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia – sequence: 10 givenname: Dragana surname: Miljic fullname: Miljic, Dragana organization: Faculty of Medicine, University of Belgrade, Belgrade, Serbia – sequence: 11 givenname: Dragan surname: Savic fullname: Savic, Dragan organization: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – sequence: 12 givenname: Mihajlo surname: Milicevic fullname: Milicevic, Mihajlo organization: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – sequence: 13 givenname: Aleksandar surname: Stanimirovic fullname: Stanimirovic, Aleksandar organization: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – sequence: 14 givenname: Vojislav surname: Bogosavljevic fullname: Bogosavljevic, Vojislav organization: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – sequence: 15 givenname: Sandra surname: Pekic fullname: Pekic, Sandra organization: Faculty of Medicine, University of Belgrade, Belgrade, Serbia – sequence: 16 givenname: Emilija surname: Manojlovic-Gacic fullname: Manojlovic-Gacic, Emilija organization: Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia – sequence: 17 givenname: Aleksandar surname: Djukic fullname: Djukic, Aleksandar organization: Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia – sequence: 18 givenname: Danica surname: Grujicic fullname: Grujicic, Danica organization: Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia – sequence: 19 givenname: Milan surname: Petakov fullname: Petakov, Milan organization: Faculty of Medicine, University of Belgrade, Belgrade, Serbia |
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| Snippet | Objective To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the... To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the transition... Objective: To analyze metabolic parameters, body composition (BC), and bone mineral density (BMD) in childhood-onset GH deficiency (COGHD) patients during the... |
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| Title | Mapping the journey of transition: a single-center study of 170 childhood-onset GH deficiency patients |
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