AUTHOR=Barrett Jefferson , Maranda Louise , Nwosu Benjamin U.

TITLE=The Relationship between Subnormal Peak-Stimulated Growth Hormone Levels and Auxological Characteristics in Obese Children

JOURNAL=Frontiers in Endocrinology

VOLUME=5

YEAR=2014

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2014.00035

DOI=10.3389/fendo.2014.00035

ISSN=1664-2392

ABSTRACT=<p><bold>Context:</bold> The hypothesis that obese children are overdiagnosed with growth hormone deficiency (GHD) has not been adequately investigated in the context of adiposity-related differences in auxology.</p><p><bold>Aim:</bold> To investigate the differences in auxological parameters between short, prepubertal, obese children, and normal-weight peers who underwent growth hormone stimulation testing (GHST).</p><p><bold>Hypothesis:</bold> Over-weight/obese children with GHD [peak growth hormone (GH) &lt; 10 μg/L] will have higher values for growth velocity (GV) standard deviation score (SDS), bone age minus chronological age (BA − CA), and child height SDS minus mid-parental height (MPTH) SDS when compared to normal-weight GHD peers.</p><p><bold>Subjects and Methods</bold>: A retrospective review of anthropometric and provocative GHST data of 67 prepubertal, GH-naïve children of age 10.21 ± 2.56 years (male <italic>n</italic> = 45, age 10.8 ± 2.60 years; female <italic>n</italic> = 22, age 8.94 ± 2.10). Inclusion criteria: GHST using arginine and clonidine. Exclusion criteria: hypopituitarism, abnormal pituitary magnetic resonance imaging scan, syndromic obesity, or syndromic short stature. Data were expressed as mean ± SD.</p><p><bold>Results:</bold> The over-weight/obese children with peak GH of &lt;10 μg/L had significantly lower value for natural log (ln) peak GH (1.45 ± 0.09 vs. 1.83 ± 0.35, <italic>p</italic> = 0.022), but similar values for GV SDS, insulin-like growth factor-I, insulin-like growth factor binding protein-3, bone age, BA − CA, MPTH, and child height SDS minus MPTH SDS compared to normal-weight peers with GHD. After adjusting for covariates, the over-weight/obese children (BMI ≥ 85th percentile) were &gt;7 times more likely than normal-weight subjects (BMI &lt; 85th percentile) to have a peak GH of &lt;10 μg/L, and 23 times more likely to have a peak GH of &lt;7 μg/L (OR = 23.3, <italic>p</italic> = 0.021). There was a significant inverse relationships between BMI SDS and the ln of peak GH (β = −0.40, <italic>r</italic><sup>2</sup> = 0.26, <italic>p</italic> = 0.001), but not for BMI SDS vs. GV SDS, ln peak GH vs. BA, or ln peak GH vs. GV SDS.</p><p><bold>Conclusion:</bold> Subnormal peak GH levels in obese prepubertal children are not associated with unique pre-GHST auxological characteristics.</p>