TY - JOUR
T1 - Prevalence of growth hormone (GH) deficiency in previously GH-treated young adults with Prader-Willi syndrome
AU - Donze, Stephany H.
AU - Damen, Layla
AU - van Alfen-van der Velden, Janiëlle A. E. M.
AU - Bocca, Gianni
AU - Finken, Martijn J. J.
AU - Hoorweg-Nijman, Gera J. G.
AU - Jira, Petr E.
AU - van Leeuwen, Mariëtte
AU - Hokken-Koelega, Anita C. S.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: Some features of subjects with Prader-Willi syndrome (PWS) resemble those seen in growth hormone deficiency (GHD). Children with PWS are treated with growth hormone (GH), which has substantially changed their phenotype. Currently, young adults with PWS must discontinue GH after attainment of adult height when they do not fulfil the criteria of adult GHD. Limited information is available about the prevalence of GHD in adults with PWS. This study aimed to investigate the GH/insulin-like growth factor (IGF-I) axis and the prevalence of GHD in previously GH-treated young adults with PWS. Design: Cross-sectional study in 60 young adults with PWS. Measurements: Serum IGF-I and IGFBP-3 levels, GH peak during combined growth hormone-releasing hormone (GHRH)-arginine stimulation test. Results: Serum IGF-I was <−2 standard deviation scores (SDS) in 2 (3%) patients, and IGFBP-3 was within the normal range in all but one patient. Median (IQR) GH peak was 17.8 μg/L (12.2; 29.7) [~53.4 mU/L] and below 9 μg/L in 9 (15%) patients. Not one patient fulfilled the criteria for adult GHD (GH peak < 9 μg/L and IGF-I < −2 SDS), also when BMI-dependent criteria were used. A higher BMI and a higher fat mass percentage were significantly associated with a lower GH peak. There was no significant difference in GH peak between patients with a deletion or a maternal uniparental disomy (mUPD). Conclusions: In a large group of previously GH-treated young adults with PWS, approximately 1 in 7 exhibited a GH peak <9 μg/L during a GHRH-arginine test. However, none of the patients fulfilled the consensus criteria for adult GHD.
AB - Objective: Some features of subjects with Prader-Willi syndrome (PWS) resemble those seen in growth hormone deficiency (GHD). Children with PWS are treated with growth hormone (GH), which has substantially changed their phenotype. Currently, young adults with PWS must discontinue GH after attainment of adult height when they do not fulfil the criteria of adult GHD. Limited information is available about the prevalence of GHD in adults with PWS. This study aimed to investigate the GH/insulin-like growth factor (IGF-I) axis and the prevalence of GHD in previously GH-treated young adults with PWS. Design: Cross-sectional study in 60 young adults with PWS. Measurements: Serum IGF-I and IGFBP-3 levels, GH peak during combined growth hormone-releasing hormone (GHRH)-arginine stimulation test. Results: Serum IGF-I was <−2 standard deviation scores (SDS) in 2 (3%) patients, and IGFBP-3 was within the normal range in all but one patient. Median (IQR) GH peak was 17.8 μg/L (12.2; 29.7) [~53.4 mU/L] and below 9 μg/L in 9 (15%) patients. Not one patient fulfilled the criteria for adult GHD (GH peak < 9 μg/L and IGF-I < −2 SDS), also when BMI-dependent criteria were used. A higher BMI and a higher fat mass percentage were significantly associated with a lower GH peak. There was no significant difference in GH peak between patients with a deletion or a maternal uniparental disomy (mUPD). Conclusions: In a large group of previously GH-treated young adults with PWS, approximately 1 in 7 exhibited a GH peak <9 μg/L during a GHRH-arginine test. However, none of the patients fulfilled the consensus criteria for adult GHD.
KW - IGF-I
KW - Prader-Willi syndrome
KW - arginine
KW - growth hormone
KW - growth hormone deficiency
KW - growth hormone-releasing hormone
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067241723&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30973645
U2 - https://doi.org/10.1111/cen.13988
DO - https://doi.org/10.1111/cen.13988
M3 - Article
C2 - 30973645
SN - 0300-0664
VL - 91
SP - 118
EP - 123
JO - Clinical endocrinology
JF - Clinical endocrinology
IS - 1
ER -