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Cited by 153Growth Hormone and Insulin-like Growth FactorsPituitary Gland Disorders and TreatmentsHypothalamic control of reproductive hormones

Treatment of Glucocorticoid-Induced Growth Suppression with Growth Hormone

Allen, David B., Julius, Joanne R., Breen, Timothy J., Attie, Kenneth M.·1998·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.83.8.5036
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Abstract

Growth failure is common during long term treatment with glucocorticoids (GC) due to blunting of GH release, insulin-like growth factor I (IGF-I) bioactivity, and collagen synthesis. These effects could theoretically be reversed with GH therapy. The National Cooperative Growth Study database (n = 22,005) was searched for children meeting the following criteria: 1) pharmacological treatment with GC and GH for more than 12 months, 2) known type and dose of GC, and 3) height measurements for more than 12 months. A total of 83 patients were identified. Monitoring of glucose, insulin, IGF-I, IGF-binding protein-3, type 1 procollagen, osteocalcin, and glycosylated hemoglobin levels was performed in a subset of patients. Stimulated endogenous GH levels were less than 10 microg/L in 51% of patients and less than 7 microg/L in 37% of patients. The mean GC dose, expressed as prednisone equivalents, was 0.5 +/- 0.6 mg/kg day. Baseline evaluation revealed extreme short stature (mean height SD score = -3.7 +/- 1.2), delayed skeletal maturation (mean delay, 3.1 yr), and slowed growth rates (mean, 3.0 +/- 2.5 cm/yr). After 12 months of GH therapy (mean dose, 0.29 mg/kg x weeks), mean growth rate increased to 6.3 +/- 2.6 cm/yr, and height SD score improved by 0.21 +/- 0.4 (P < 0.01). During the second year of GH therapy (n = 44), the mean growth rate was 6.3 +/- 2.0 cm/yr. Prednisone equivalent dose and growth response to GH therapy were negatively correlated (r = -0.264; P < 0.05). Plasma concentrations of IGF-I, IGF-binding protein-3, procollagen, osteocalcin, and glycosylated hemoglobin increased with GH therapy, whereas glucose and insulin levels did not change. The following conclusions were reached. The growth-suppressing effects of GC are counterbalanced by GH therapy; the mean response is a doubling of baseline growth rate. Responsiveness to GH is negatively correlated with GC dose. Glycosylated hemoglobin levels increased slightly, but glucose and insulin levels were not altered by GH therapy.

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  • Children treated with chronic glucocorticoids normally have growth retardation including suppression of bone growth.

    “Children treated with chronic GCs normally have growth retardation including the suppression of bone growth [8, 9].”

    From Prevention of glucocorticoid induced bone changes with beta-ecdysone (2015) · cites this paper as [9]

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Authors
Allen, D. B., Julius, J. R., Breen, T. J., & Attie, K. M.
Affiliations
  • University of Wisconsin–Madison (US)
  • Genentech (US)
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1998-08
Volume
83
Issue
8
Pages
2824-2829
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem.83.8.5036
OpenAlex
W2008051025
Cited by
153
References
34
Citations by year
2026: 1 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 9 · 2016: 4 · 2015: 7 · 2014: 6 · 2013: 4 · 2012: 5
FWCI
3.51
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
growth hormone therapy, glucocorticoids, growth failure, short stature, insulin-like growth factor I, IGF binding protein-3, growth rate, glucocorticoid dose, HbA1c, pediatric patients, delayed skeletal maturation, osteocalcin, procollagen
MeSH terms
Adolescent, Blood Glucose, Body Height, Child, Female, Glucocorticoids, Growth Disorders, Glycated Hemoglobin, Humans, Insulin, Insulin-Like Growth Factor I, Male, Procollagen, Retrospective Studies, Cohort Studies, Osteocalcin, Insulin-Like Growth Factor Binding Protein 3, Human Growth Hormone

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