Growth hormone therapy in children with idiopathic short stature – the effect on appetite and appetite-regulating hormones: a pilot study. (3rd April 2019)

• Record Type: Journal Article
• Authors: Yackobovitch-Gavan, Michal; Gat-Yablonski, Galia; Shtaif, Biana; Hadani, Shir; Abargil, Shiran; Phillip, Moshe; Lazar, Liora
• Is Part Of: Endocrine research. Volume 44:Number 1/2(2019)
• Page Start: 16
• Page End: 26
• Publication Date: 2019-04-03
• Subjects: Ghrelin -- GLP-1 -- Insulin -- Leptin -- standard meal test; Endocrinology, Experimental -- Periodicals; Endocrinology -- Periodicals; Endocrinology -- Periodicals; Research -- Periodicals; 616.4
• DOI: 10.1080/07435800.2018.1493598
• Languages: English
• ISSNs: 0743-5800

Abstract

ABSTRACT: Aim : To investigate the effect of growth hormone (GH) therapy on appetite-regulating hormones and to examine the association between these hormones and the response to GH, body composition, and resting energy expenditure (REE). Methods : Nine pre-pubertal children with idiopathic short stature underwent a standard meal test before and 4 months following initiation of GH treatment. Ghrelin, GLP-1, leptin, and insulin levels were measured; area under the curve (AUC) was calculated. Height, weight, body composition, REE, and insulin-like growth factor levels were recorded at baseline and after 4 and 12 months. Results : Following 4 months of GH therapy, food intake increased, with increased height-standard deviation score (SDS), weight-SDS, and REE ( p < .05). Significant changes in appetite-regulating hormones included a decrease in postprandial AUC ghrelin levels ( p = .045) and fasting GLP-1 ( p = .038), and an increase in fasting insulin ( p = .043). Ghrelin levels before GH treatment were positively correlated with the changes in weight-SDS (fasting: r = .667, p = .05; AUC: r = .788, p = .012) and REE (fasting: r = .866, p = .005; AUC: r = .847, p = .008) following 4 months of GH therapy. Ghrelin AUC at 4 months was positively correlated with the changes in height-SDS ( r = .741, p = .022) and fat-free-mass ( r = .890, p = .001) at 12 months of GH treatment. Conclusions : The reduction in ghrelin and GLP-1 following GH treatment suggests a role for GH in appetite regulation. Fasting and meal-AUC ghrelin levels may serve as biomarkers for predicting short-term (4 months) changes in weight and longer term (12 months) changes in height following GH treatment. The mechanisms linking GH with changes in appetite-regulating hormones remain to be elucidated. Abbreviations: SDS: standard deviation score; REE: resting energy expenditure; SMT: standard meal test; AUC: area under the curve; ISS: idiopathic short stature; SGA: small for gestational age; FFM: fat-free-mass; FM: fat mass; EER: estimated energy requirements; DRI: dietary reference intakes; IQR: inter-quartile range