Document Detail


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.
MedLine Citation:
PMID:  21470283     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 (0·067 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 4·5 (range, 0·6, 8·9) at baseline to 10·8 (6·1, 15·0) cm/year at 6 month (P = 0·003) in the rhGH group, whereas in the Ctrl group, it was 3·8 (1·4, 6·7) and 3·5 cm/year (2·0, 9·6), respectively (P = 0·58). Median percentage increase in HV after 6 months in the rhGH group was 140% (16·7, 916·7) compared with 17·4% (-42·1%, 97·7%) in the Ctrl group (P < 0·001). 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 4·0 (2·0, 11·0) to 7·0 mU/l (2·0, 16·0) (P = 0·02), whereas in the Ctrl group, it was 3·0 (1·2, 12·7) and 3·8 mU/l (2·1, 7·0) (P = 0·72), 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.
Authors:
S C Wong; P Kumar; P J Galloway; J C Blair; M Didi; A M Dalzell; K Hassan; P McGrogan; S Faisal Ahmed
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical endocrinology     Volume:  74     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  599-607     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Developmental Endocrinology Research Group, Royal Hospital for Sick Children, Glasgow Department of Endocrinology, Royal Liverpool Children's Hospital, Liverpool Department of Biochemistry, Royal Hospital for Sick Children, Glasgow Department of Gastroenterology, Royal Liverpool Children's Hospital, Liverpool Department of Gastroenterology, Hepatology and Nutrition, Royal Hospital for Sick Children, Glasgow, UK.
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