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
| Autor: | Mahoko Furujo, Motoharu Ochi, Yousuke Higuchi, Takahiro Namba, Yuki Ebuchi, Hiroki Tsuchiya, Shoko Fujinaga, Naoko Urata, Toshihide Kubo, Michiko Kishi, Narumi Hara |
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| Rok vydání: | 2020 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Time Factors Adolescent Hormone Replacement Therapy Endocrinology Diabetes and Metabolism Thyroid Gland Levothyroxine Thyrotropin-releasing hormone 030209 endocrinology & metabolism Thyroid Function Tests Growth hormone deficiency 03 medical and health sciences 0302 clinical medicine Endocrinology TRH stimulation test Hypothyroidism Japan Predictive Value of Tests Internal medicine Central hypothyroidism medicine Humans Child Thyrotropin-Releasing Hormone Growth Disorders Retrospective Studies Human Growth Hormone business.industry Infant Newborn medicine.disease Thyroid Diseases Child Preschool Infant Small for Gestational Age Pediatrics Perinatology and Child Health IGHD Female Thyroid function business hormones hormone substitutes and hormone antagonists Follow-Up Studies 030215 immunology medicine.drug Hormone |
| Zdroj: | Journal of Pediatric Endocrinology and Metabolism. 33:1417-1423 |
| ISSN: | 2191-0251 0334-018X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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