Factors for persistent growth hormone deficiency in young adults with childhood onset growth hormone deficiency

Lee, Young Ah; Chung, Hye Rim; Lee, Se Min; Kim, Jae Hyun; Kim, Ji Hyun; Lee, Sun Hee; Shin, Choong Ho; Yang, Sei Won

Original Article

Korean Journal of Pediatrics 2009;52(2):227-233.
Published online February 15, 2009.

Factors for persistent growth hormone deficiency in young adults with childhood onset growth hormone deficiency

Young Ah Lee¹, Hye Rim Chung¹, Se Min Lee², Jae Hyun Kim¹, Ji Hyun Kim¹, Sun Hee Lee¹, Choong Ho Shin¹, Sei Won Yang¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
²Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea

소아청소년기 성장호르몬결핍증의 성인기 지속에 영향을 미치는 요인

이영아^¹^, 정혜림^¹^, 이세민^²^, 김재현^¹^, 김지현^¹^, 이선희^¹^, 신충호^¹^, 양세원^¹

^¹서울대학교 의과대학 소아과학교실
^²한양대학교 의과대학 소아과학교실

Correspondence:
Choong Ho Shin, Email: chshinpd@snu.ac.kr

Abstract

Purpose
: Growth hormone (GH) replacement after retesting is necessary because impairment of body composition and cardiovascular health has been more severe in adult patients with persistent GH deficiency (GHD) from childhood to adulthood. This study aimed to investigate the factors for persistent GHD and define a highly probable group of persistent GHD in young adults with childhood-onset GHD.
Methods
: GHD was reassessed by insulin tolerance test (ITT) in 55 adult patients (39 males, 16 females) with childhood- onset GHD. Twelve patients presented with idiopathic GHD and 43 patients presented with organic GHD caused by tumors involving the hypothalamus-pituitary (H-P) region (n=33), other brain tumors (n=3), meningitis (n=3), leukemia (n=2) and others (n=2).
Results
: Forty-nine (89.1%) of 55 patients had persistent GHD. IGF-I was positively correlated with log of peak GH (r=0.57, P<0.001). There was no difference in the proportion of persistent GHD between idiopathic and organic GHD. The percentage of patients with persistent GHD was 40%, 80%, and 95.6% for patients with zero, one, two or more additional pituitary hormone deficiencies (PHDs), respectively (P=0.002). The probability of persistent GHD was higher in patients with diseases involving the H-P region (P=0.003). GHD persisted in 15 of 18 patients treated with cranial irradiation.
Conclusion
: We suggest that the probability of persistent GHD in adulthood was high in patients with 2 or more additional PHDs, and diseases involving the H-P region.

Key Words: Growth hormone deficiency, Insulin tolerance test, Adult, Child