A preliminary trial of the effect of recombinant human growth hormone on short-term linear growth and glucose homeostasis in children with Crohn’s disease

Wong, S.C. , Kumar, P., Galloway, P., Blair, J.C., Didi, M., Dalzell, A.M., Hassan, K., McGrogan, P. and Ahmed, S.F. (2011) A preliminary trial of the effect of recombinant human growth hormone on short-term linear growth and glucose homeostasis in children with Crohn’s disease. Clinical Endocrinology, 74(5), pp. 599-607. (doi: 10.1111/j.1365-2265.2011.03977.x)

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Publisher's URL: http://dx.doi.org/10.1111/j.1365-2265.2011.03977.x

Abstract

Background: It is unclear whether recombinant human growth hormone (rhGH) improves linear growth in children with Crohn's disease (CD). Aims: To investigate the effects of rhGH on height velocity (HV) and glucose homeostasis over a 6-month period. Design and setting: Randomized controlled trial in two tertiary children's hospitals in 22 children with inflammatory bowel disease amongst whom 21 had CD. Duration of disease from diagnosis and number of acute relapses requiring either exclusive enteral nutrition or therapeutic dose of oral prednisolone were similar in the treatment and control groups. Intervention: Either rhGH (0 center dot 067 mg/kg per day) as daily subcutaneous injections (rhGH group; n, 11) or no rhGH, (Ctrl; n, 11) for 6 months. Main outcome measure: Percentage change in HV after 6 months in the two groups. Auxology, puberty, skeletal age, disease factors, treatment and glucose homeostasis were also assessed. Results: Median HV increased from 4 center dot 5 (range, 0 center dot 6, 8 center dot 9) at baseline to 10 center dot 8 (6 center dot 1, 15 center dot 0) cm/year at 6 month (P = 0 center dot 003) in the rhGH group, whereas in the Ctrl group, it was 3 center dot 8 (1 center dot 4, 6 center dot 7) and 3 center dot 5 cm/year (2 center dot 0, 9 center dot 6), respectively (P = 0 center dot 58). Median percentage increase in HV after 6 months in the rhGH group was 140% (16 center dot 7, 916 center dot 7) compared with 17 center dot 4% (-42 center dot 1%, 97 center dot 7%) in the Ctrl group (P < 0 center dot 001). There were no significant differences in disease activity and proinflammatory cytokines at baseline and 6 months in both groups and change in bone age for chronological age was also similar in the two groups. In the rhGH group, fasting insulin increased from 4 center dot 0 (2 center dot 0, 11 center dot 0) to 7 center dot 0 mU/l (2 center dot 0, 16 center dot 0) (P = 0 center dot 02), whereas in the Ctrl group, it was 3 center dot 0 (1 center dot 2, 12 center dot 7) and 3 center dot 8 mU/l (2 center dot 1, 7 center dot 0) (P = 0 center dot 72), respectively. Conclusions: Although this pilot trial shows that rhGH can improve short-term linear growth in children with CD, the clinical efficacy of this therapy needs to be further studied in longer-term studies of growth, glucose homeostasis and disease status.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wong, Dr Jarod and Galloway, Dr Peter and Ahmed, Professor Syed Faisal
Authors: Wong, S.C., Kumar, P., Galloway, P., Blair, J.C., Didi, M., Dalzell, A.M., Hassan, K., McGrogan, P., and Ahmed, S.F.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Endocrinology
Publisher:Blackwell Publishing
ISSN:0300-0664

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