Korean J Pediatr.  2009 Feb;52(2):227-233. 10.3345/kjp.2009.52.2.227.

Factors for persistent growth hormone deficiency in young adults with childhood onset growth hormone deficiency

• Lee YA
• Chung HR
• Lee SM
• Kim JH
• Kim JH
• Lee SH
• Shin CH
• Yang SW

• KMID: 2281680
• DOI: http://doi.org/10.3345/kjp.2009.52.2.227

Abstract

PURPOSE: Growth hormone (GH) replacement after retesting is necessary because impairment of body composition and cardiovascular health has been more severe in adult patients with persistent GH deficiency (GHD) from childhood to adulthood. This study aimed to investigate the factors for persistent GHD and define a highly probable group of persistent GHD in young adults with childhood-onset GHD.
METHODS
GHD was reassessed by insulin tolerance test (ITT) in 55 adult patients (39 males, 16 females) with childhood-onset GHD. Twelve patients presented with idiopathic GHD and 43 patients presented with organic GHD caused by tumors involving the hypothalamus-pituitary (H-P) region (n=33), other brain tumors (n=3), meningitis (n=3), leukemia (n=2) and others (n=2).
RESULTS
Forty-nine (89.1%) of 55 patients had persistent GHD. IGF-I was positively correlated with log of peak GH (r=0.57, P<0.001). There was no difference in the proportion of persistent GHD between idiopathic and organic GHD. The percentage of patients with persistent GHD was 40%, 80%, and 95.6% for patients with zero, one, two or more additional pituitary hormone deficiencies (PHDs), respectively (P=0.002). The probability of persistent GHD was higher in patients with diseases involving the H-P region (P=0.003). GHD persisted in 15 of 18 patients treated with cranial irradiation.
CONCLUSION
We suggest that the probability of persistent GHD in adulthood was high in patients with 2 or more additional PHDs, and diseases involving the H-P region.

Keyword

Growth hormone deficiency; Insulin tolerance test; Adult; Child

MeSH Terms

Adult
Body Composition
Brain Neoplasms
Child
Cranial Irradiation
Growth Hormone
Humans
Insulin
Insulin-Like Growth Factor I
Leukemia
Male
Meningitis
Young Adult
Growth Hormone
Insulin
Insulin-Like Growth Factor I