ABSTRACT
Irisin (Ir) deficiency may be a contributing factor in metabolic disease. This study aimed to investigate the effect of supraphysiological doses of recombinant human growth hormone (rhGH) on Ir plasma concentration in relation to metabolic disorders, including obesity and other components of metabolic syndrome. We studied 36 girls with Turner syndrome (mean age 8.2 years) treated with rhGH (0.05 mg/kg/day). Anthropometric data and fasting blood levels [e. g., Ir, insulin, glucose, glycated hemoglobin (HbA1c), IGF-1, IGFBP-3, cholesterol, insulin resistance (HOMA-IR), and ß-cell function (HOMA-ß)] were analyzed prior to and following rhGH therapy [mean (SD) follow-up of 1.47 (0.89) years]. Insulin sensitivity (Matsuda index) was calculated before and after the glucose load. Following rhGH therapy, an increase in IGF-1 [mean (SD) of 119.40 (62.47) ng/ml to 439.08 (209.91) ng/ml, p=0.000], Ir [2.10 (1.03) µg/ml to 2.48 (0.78) µg/ml, p=0.036], HOMA-IR [median (IQR) of 0.64 (0.45-1.30) to 0.92 (0.67-2.36), p=0.0206], and HOMA-ß values [45.00 (27.69-72.00) to 81.53 (51.43-132.00), p=0.0447] were observed. Multiple regression analysis yielded no associations between Ir and metabolic and hormonal parameters before rhGH treatment; however, on rhGH, the model (R2=0.56, adjusted R2=0.45) showed positive associations between Ir and IGF-1 standard deviation score and HbA1c, and negative associations between Ir and fasting blood glucose, HDL-cholesterol, and triglycerides. Despite manifestation of insulin resistance, rhGH application had a positive effect on Ir regulation, and restored physiological conditions of lipid and glucose metabolism.
Subject(s)
Fibronectins/blood , Human Growth Hormone/therapeutic use , Turner Syndrome/blood , Turner Syndrome/drug therapy , Adolescent , Blood Glucose/metabolism , Child , Child, Preschool , Fasting/blood , Female , Humans , Insulin/blood , Insulin Resistance , Insulin-Like Growth Factor I/metabolism , Insulin-Secreting Cells/drug effects , Insulin-Secreting Cells/metabolism , Insulin-Secreting Cells/pathology , Karyotyping , Multivariate Analysis , Regression AnalysisABSTRACT
The relations between diabetes type 1 and growth disturbances have been controversial. The aim of the study was to estimate the IGF-1 and IGFBP-3 levels in the group of children with diabetes type 1 and growth disturbances. The study group consisted of 22 children (10 males and 12 females) aged 11.96+/-3.38, bone aged 10.70+/-3.91, GV SDS < -0.93 below the mean for C. A. IGF-1, IGFBP-3, GH stimulation test, TSH, fT4 and HbA1 were determined. In the studied group positive correlations between: IGF-1 and IGFBP-3; IGF-1 and BMI; BMI and IGFBP-3 were determined. In children with diabetes type 1. The IGF-1 concentration was significantly higher when the sceletal age was delayed above 1 year in comparison with children with delaying of the sceletal age bellow 1 year and it was independent on results of GH stimulation tests.
ABSTRACT
Hamartoma of the hypothalamic region is known as one of the reasons of precocious puberty. The case of a 15-month old boy with hamartoma as a reason of precocious puberty is presented. The GnRH analogues were used in the therapy.
ABSTRACT
UNLABELLED: Due to the screening examination it is possible to diagnose primary hypothyreosis at the very beginning. On the other hand, hypothyreosis may be also caused by insufficient secretion of TSH or TRH. We present a 13-month old boy (A.I.) admitted to our Department because of short stature. The child was from normal pregnancy, birth spontaneous at full term with weight 4400 g, length 56 cm, 10 points in Apgar scale, TSH - 1,87 micro IU/ml in the screening examination. The psychomotor development was normal. At the admission the height was 72 cm (below 3 c), weight - 10,1 kg, body proportions normal, atresic fontanels, 7 teeth. Additional examinations revealed: skeletal age - 3 months, blood cell count normal, biochemical examinations normal except for level of cholesterol (209 mg/dl). We found lack of the GH secretion after clonidine. TSH value was slightly above normal range. The levels of free thyroid hormones, anti-TPO antibodies and thyroid ultrasonography were normal. The TSH level was increased in the stimulation test with TRH. Result of the MR examination of the brain was normal. On the basis of the whole picture tertiary hypothyreosis can not be excluded. The normalisation of thyroid hormone levels and GH in stimulation test with glucagone was obtained after therapy with L-thyroxine. CONCLUSION: In cases of unclear growing disorders the full diagnostics of the hypothalamic-hypophyseal-thyroid axis should be done because of the possibility of regulatory centres insufficiency.
