eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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3/2018
vol. 43
 
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abstract:
Clinical immunology

Thyroid function in children with growth hormone deficiency during long-term growth hormone replacement therapy

Ewelina Witkowska-Sędek, Ada Borowiec, Anna Majcher, Maria Sobol, Małgorzata Rumińska, Beata Pyrżak

(Centr Eur J Immunol 2018; 43 (3): 255-261)
Online publish date: 2018/10/30
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Aim of the study
The aim of this study was to investigate the effects of growth hormone (GH) therapy on thyroid function in a group of euthyroid children with isolated idiopathic growth hormone deficiency (GHD).

Material and methods
The study was retrospective and included 117 children treated with GH for 1-4 years. Anthropometric measurements and serum concentrations of insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH), and free thyroxine (fT4) were analysed at baseline and during GH therapy.

Results
TSH levels did not change significantly after the initiation of GH treatment, while fT4 levels decreased after the second year of GH treatment (p < 0.01) and remained lower than baseline until the end of observation (p < 0.01, after both the third and fourth year of therapy) in the whole group. Analysis according to baseline pubertal status revealed significant changes in TSH and fT4 levels during GH treatment, but only in the prepubertal children. Multiple regression analysis confirmed that mean GH doses administered in the first two years of GH therapy were independently (R = 0.218, p < 0.05) associated with changes in fT4 levels in this period (∆fT42 years – baseline), even when taking into account changes in height SDS and bone age.

Conclusions
FT4 levels decreased during GH replacement therapy, while TSH levels appeared to be unaffected by GH therapy. Prepubertal children seem to be more predisposed to thyroid function alterations during such therapy in comparison to pubertal children. Changes in fT4 levels during GH replacement therapy are related to GH doses.

keywords:

growth hormone/insulin-like growth factor-1 axis, thyroid function, growth hormone deficiency, growth hormone replacement therapy, children

references:
Giavoli C, Profka E, Rodari G, et al. (2017): Focus on GH deficiency and thyroid function. Best Pract Res Clin Endocrinol Metab 31: 71-78.
Behan LA, Monson JP, Agha A (2011): The interaction between growth hormone and the thyroid axis in hypopituitary patients. Clin Endocrinol (Oxf) 74: 281-288.
Lewiński A, Marcinkowska M (2015): Acromegaly and the thyroid gland. Thyroid Res 8 (Suppl 1): A20.
Akin F, Yaylali GF, Turgut S, Kaptanoglu B (2009): Growth hormone/insulin like growth factor axis in patients with subclinical thyroid dysfunction. Growth Horm IGF Res 19: 252-255.
Glynn N, Kenny H, Salim T, et al. (2018): Alterations in thyroid hormone levels following growth hormone replacement exert complex biological effects. Endocr Pract 24: 342-350.
Giavoli C, Porretti S, Ferrante E, et al. (2003): Recombinant hGH replacement therapy and the hypothalamus-pituitary-thyroid axis in children with GH deficiency: when we be concerned about the occurrence of central hypothyroidism? Clin Endocrinol (Oxf) 59: 806-810.
Wyatt DT, Gesundheit N, Sherman B (1998): Changes in thyroid hormone levels during growth hormone therapy in initially euthyroid patients: lack of need for thyroxine supplementation. J Clin Endocrinol Metab 83: 3493-3497.
Portes ES, Oliveira JHA, MacCagnan P, Abucham J (2000): Changes in serum thyroid hormones levels and their mechanisms during long-term growth hormone (GH) replacement therapy in GH deficient children. Clin Endocrinol (Oxf) 53: 183-189.
Lakatos P, Foldes J, Nagy Z, et al. (2000): Serum insulin-like growth factor-I, insulin-like growth factor binding proteins, and bone mineral content in hyperthyroidism. Thyroid 10: 417-423.
Witkowska-Sędek E, Kucharska A, Rumińska M, Pyrżak B (2017): Thyroid dysfunction in obese and overweight children. Endokrynol Pol 68: 54-60.
Witkowska-Sędek E, Borowiec A, Kucharska A, et al. (2017): Thyroid Autoimmunity in Girls with Turner Syndrome. Adv Exp Med Biol 1022: 71-76.
Puzianowska-Kuźnicka M, Pietrzak M, Turowska O, Nauman A (2006): Thyroid hormones and their receptors in the regulation of cell proliferation. Acta Biochim Pol 53: 641-650.
Valcavi R, Valente F, Dieguez C, et al. (1993): Evidence against depletion if the growth hormone releasable pool in human primary hypothyroidism: studies with GH-releasing hormone, pyridostigmine and arginine. J Clin Endocrinol Metab 77: 616-620.
Co Ng LL, Lang CH, Bereket A, et al. (2000): Effect of hyperthyroidism on insulin-like growth factor-I (IGF-I) and IGF-binding proteins in adolescent children. J Pediatr Endocrinol Metab 13: 1073-1080.
Inukai T, Takanashi K, Takabayashi K, et al. (1999): Thyroid hormone modulates insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3, without mediation by growth hormone, in patients with autoimmune thyroid diseases. Horm Metab Res 20: 213-216.
Iranmanesh A, Lizarralde G, Johnson ML, Veldhuis JD (1991): Nature of altered growth hormone secretion in hyperthyroidism. J Clin Endocrinol Metab 72: 108-115.
Chernausek SD, Turner R (1989): Attenuation of spontaneous nocturnal growth hormone secretion in children with hypothyroidism and its correlation with plasma insulin like growth factor 1 concentrations. J Pediatr 114: 968-972.
Laron Z (2003): Interactions between the thyroid hormones and the hormones of the growth hormone axis. Pediatr Endocrinol Rev 1 (Suppl 2): 244-249; discussion: 250.
Grunfeld C, Sherman BM, Cavalieri RR (1988): The acute effects of human growth hormone administration on thyroid function in normal men. J Clin Endocrinol Metab 67: 1111-1114.
Jørgensen JO, Pedersen SB, Børglum J, et al. (1994): Fuel metabolism, energy expenditure, and thyroid function in growth hormone treated obese women: a double blind placebo controlled study. Metabolism 43: 872-877.
Rose SR, Leong GM, Yanovski JA, et al. (1995): Thyroid function in non-growth hormone deficient short children during a placebo controlled double blind trial of recombinant growth hormone therapy. J Clin Endocrinol Metab 80: 320-324.
Smyczyńska J, Hilczer M, Stawerska R, Lewiński A (2010): Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy – clinical implications. Thyroid Res 3: 2.
Witkowska-Sędek E, Rumińska M, Stelmaszczyk-Emmel A, et al. (2018): The associations between the growth hormone/insulin-like growth factor-1 axis, adiponectin, resistin and metabolic profile in children with growth hormone deficiency before and during growth hormone treatment. Acta Biochim Pol 65: 333-340.
Glynn N, Kenny H, Quisenberry L, et al. (2017): The effect of growth hormone replacement on the thyroid axis in patients with hypopituitarism: in vivo and ex vivo studies. Clin Endocrinol (Oxf) 86: 747-754.
Keskin M, Bayramoglu E, Aycan Z (2017): Effects of 1-year growth hormone replacement therapy on thyroid volume and function of the children and adolescents with idiopathic growth hormone deficiency. J Pediatr Endocrinol Metab 30: 1187-1190.
Seminara S, Stagi S, Candura L, et al. (2005): Changes of thyroid function during long term hGH therapy in GHD children. A possible relationship with catch up growth? Horm Metab Res 37: 751-756.
Porretti S, Giavoli C, Ronchi C, et al. (2002): Recombinant human GH replacement therapy and thyroid function in a large group of adult GH-deficient patients: when does L-T(4) therapy become mandatory? J Clin Endocrinol Metab 87: 2042-2045.
Jørgensen JO, Møller J, Laursen T, et al. (1994): Growth hormone administration stimulates energy expenditure and extrathyroidal conversion of thyroxine to triiodothyronine in a dose-dependent manner and suppresses circadian thyrotrophin levels: studies in GH-deficient adults. Clin Endocrinol (Oxf) 41: 609-614.
Hussain MA, Schmitz O, Jørgensen JO, et al. (1996): Insulin-like growth factor I alters peripheral thyroid hormone metabolism in humans: comparison with growth hormone. Eur J Endocrinol 134: 563-567.
Kalina-Faska B, Kalina M, Koehler B (2004): Effects of recombinant growth hormone therapy on thyroid hormone concentrations. Int J Clin Pharmacol Ther 42: 30-34.
Agha A, Walker D, Perry L, et al. (2007): Unmasking of central hypothyroidism following growth hormone replacement in adult hypopituitary patients. Clin Endocrinol (Oxf) 66: 72-77.
Tanner JM (1962): Growth at adolescence. Blackwell, Oxford.
Leczenie niskorosłych dzieci z somatotropinową niedoczynnością przysadki (ICD10 E23) hormonem wzrostu. Obwieszczenie Ministra Zdrowia z dnia 26 sierpnia 2015 r. w sprawie wykazu refundowanych leków, środków spożywczych specjalnego przeznaczenia żywieniowego oraz wyrobów medycznych (Dz. Urz. MZ 2015; 42: zał. B.19).
Greulich WW, Pyle SI (1969): Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Stanford.
Palczewska I, Niedźwiecka Z (2001): Wskaźniki rozwoju somatycznego dzieci i młodzieży warszawskiej. Med Wieku Rozwoj 5 (Suppl 1): 1-120.
Losa M, Scavini M, Gatti E, et al. (2008): Long-term effects of growth hormone replacement on thyroid function in adults with growth hormone deficiency. Thyroid 18: 1249-1254.
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