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Rapid cardiovascular effects of growth hormone treatment in short prepubertal children: impact of treatment duration

Nygren, Anders; Sunnegardh, Jan; Teien, Dag; Jonzon, Anders; Björkhem, Gudrun LU ; Lindell, Sven; Albertsson-Wikland, Kerstin and Kristrom, Berit (2012) In Clinical Endocrinology 77(6). p.877-884
Abstract
Objective Previous studies show that growth hormone (GH) treatment increases cardiac dimensions in short children with GH deficiency (GHD) and has diverse cardiac effects in children with idiopathic short stature (ISS). This study was performed to assess the effect of GH on the cardiovascular system in short children with a broad range of GH secretion and GH sensitivity/responsiveness. Design and patients In this prospective, multicentre study, short prepubertal children diagnosed with isolated GHD (89) or ISS (38) were followed during 2 years of GH treatment. They were randomized to receive either a standard (43 mu g/kg/day) or an individualized GH dose (range 17100 mu g/kg/day) based on GH responsiveness estimated by a prediction model... (More)
Objective Previous studies show that growth hormone (GH) treatment increases cardiac dimensions in short children with GH deficiency (GHD) and has diverse cardiac effects in children with idiopathic short stature (ISS). This study was performed to assess the effect of GH on the cardiovascular system in short children with a broad range of GH secretion and GH sensitivity/responsiveness. Design and patients In this prospective, multicentre study, short prepubertal children diagnosed with isolated GHD (89) or ISS (38) were followed during 2 years of GH treatment. They were randomized to receive either a standard (43 mu g/kg/day) or an individualized GH dose (range 17100 mu g/kg/day) based on GH responsiveness estimated by a prediction model and distance to target height. Echocardiography, blood pressure and electrocardiography were performed at baseline, 3, 12 and 24 months. Results Left ventricular mass (LVM) indexed to body surface area increased significantly during 2 years of GH treatment in both GHD and ISS irrespective of randomized dose. This change was already apparent at 3 months, when standard deviation scores (SDS) of wall thickness and diameter were increased. At 24 months, left ventricular diameter SDS remained increased, whereas myocardial thickness SDS returned to baseline values. There was no impairment of systolic or diastolic function. There was no correlation with treatment dose and LVM SDS at 24 months. Conclusions Irrespective of GH status, there was a rapid increase in LVM during GH treatment in short children. At 3 months, wall thickness and diameter were increased, whereas only diameter remained increased at 24 months. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Endocrinology
volume
77
issue
6
pages
877 - 884
publisher
Wiley-Blackwell
external identifiers
  • wos:000310962800014
  • scopus:84869005668
ISSN
1365-2265
DOI
10.1111/j.1365-2265.2012.04456.x
language
English
LU publication?
yes
id
415d86d8-c5c3-426c-b587-911b6b66f7a5 (old id 3492267)
date added to LUP
2013-03-01 07:50:52
date last changed
2017-01-22 03:11:16
@article{415d86d8-c5c3-426c-b587-911b6b66f7a5,
  abstract     = {Objective Previous studies show that growth hormone (GH) treatment increases cardiac dimensions in short children with GH deficiency (GHD) and has diverse cardiac effects in children with idiopathic short stature (ISS). This study was performed to assess the effect of GH on the cardiovascular system in short children with a broad range of GH secretion and GH sensitivity/responsiveness. Design and patients In this prospective, multicentre study, short prepubertal children diagnosed with isolated GHD (89) or ISS (38) were followed during 2 years of GH treatment. They were randomized to receive either a standard (43 mu g/kg/day) or an individualized GH dose (range 17100 mu g/kg/day) based on GH responsiveness estimated by a prediction model and distance to target height. Echocardiography, blood pressure and electrocardiography were performed at baseline, 3, 12 and 24 months. Results Left ventricular mass (LVM) indexed to body surface area increased significantly during 2 years of GH treatment in both GHD and ISS irrespective of randomized dose. This change was already apparent at 3 months, when standard deviation scores (SDS) of wall thickness and diameter were increased. At 24 months, left ventricular diameter SDS remained increased, whereas myocardial thickness SDS returned to baseline values. There was no impairment of systolic or diastolic function. There was no correlation with treatment dose and LVM SDS at 24 months. Conclusions Irrespective of GH status, there was a rapid increase in LVM during GH treatment in short children. At 3 months, wall thickness and diameter were increased, whereas only diameter remained increased at 24 months.},
  author       = {Nygren, Anders and Sunnegardh, Jan and Teien, Dag and Jonzon, Anders and Björkhem, Gudrun and Lindell, Sven and Albertsson-Wikland, Kerstin and Kristrom, Berit},
  issn         = {1365-2265},
  language     = {eng},
  number       = {6},
  pages        = {877--884},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical Endocrinology},
  title        = {Rapid cardiovascular effects of growth hormone treatment in short prepubertal children: impact of treatment duration},
  url          = {http://dx.doi.org/10.1111/j.1365-2265.2012.04456.x},
  volume       = {77},
  year         = {2012},
}