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Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency

BACKGROUND: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in...

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Autores principales: Lee, Yun Jeong, Choi, Yunha, Yoo, Han-Wook, Lee, Young Ah, Shin, Choong Ho, Choi, Han Saem, Kim, Ho-Seong, Kim, Jae Hyun, Moon, Jung Eun, Ko, Cheol Woo, Ahn, Moon Bae, Suh, Byung-Kyu, Choi, Jin-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Endocrine Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081298/
https://www.ncbi.nlm.nih.gov/pubmed/35504604
http://dx.doi.org/10.3803/EnM.2021.1384
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author Lee, Yun Jeong
Choi, Yunha
Yoo, Han-Wook
Lee, Young Ah
Shin, Choong Ho
Choi, Han Saem
Kim, Ho-Seong
Kim, Jae Hyun
Moon, Jung Eun
Ko, Cheol Woo
Ahn, Moon Bae
Suh, Byung-Kyu
Choi, Jin-Ho
author_facet Lee, Yun Jeong
Choi, Yunha
Yoo, Han-Wook
Lee, Young Ah
Shin, Choong Ho
Choi, Han Saem
Kim, Ho-Seong
Kim, Jae Hyun
Moon, Jung Eun
Ko, Cheol Woo
Ahn, Moon Bae
Suh, Byung-Kyu
Choi, Jin-Ho
author_sort Lee, Yun Jeong
collection PubMed
description BACKGROUND: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period. METHODS: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption. RESULTS: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates. CONCLUSION: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.
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spelling pubmed-90812982022-05-16 Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency Lee, Yun Jeong Choi, Yunha Yoo, Han-Wook Lee, Young Ah Shin, Choong Ho Choi, Han Saem Kim, Ho-Seong Kim, Jae Hyun Moon, Jung Eun Ko, Cheol Woo Ahn, Moon Bae Suh, Byung-Kyu Choi, Jin-Ho Endocrinol Metab (Seoul) Original Article BACKGROUND: Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period. METHODS: This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption. RESULTS: Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates. CONCLUSION: GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period. Korean Endocrine Society 2022-04 2022-04-25 /pmc/articles/PMC9081298/ /pubmed/35504604 http://dx.doi.org/10.3803/EnM.2021.1384 Text en Copyright © 2022 Korean Endocrine Society https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Yun Jeong
Choi, Yunha
Yoo, Han-Wook
Lee, Young Ah
Shin, Choong Ho
Choi, Han Saem
Kim, Ho-Seong
Kim, Jae Hyun
Moon, Jung Eun
Ko, Cheol Woo
Ahn, Moon Bae
Suh, Byung-Kyu
Choi, Jin-Ho
Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title_full Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title_fullStr Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title_full_unstemmed Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title_short Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency
title_sort metabolic impacts of discontinuation and resumption of recombinant human growth hormone treatment during the transition period in patients with childhood-onset growth hormone deficiency
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081298/
https://www.ncbi.nlm.nih.gov/pubmed/35504604
http://dx.doi.org/10.3803/EnM.2021.1384
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