OBJECTIVETo study the serum levels of insulin-like growth factor I(IGF-I)and growth hormone (GH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to investigate the relationship of serum levels of IGF-I and GH with the severity of HIE.

METHODSSerum levels of IGF-I and GH were measured within 72 hrs (acute stage) and on the 26-28th days (convalescence stage) of life in 53 HIE neonates. There were 30 babies in the mild HIE group, 15 babies in the moderate HIE group, and 9 babies in the severe HIE group. Thirty normal newborns were used as the control group. Neonatal behavioral neurological assessment (NBNA) was performed on HIE neonates at the acute and convalescence stages.

RESULTSThe IGF-I levels of the mild, moderate and severe HIE groups measured within 72 hrs of life were 59.65 +/- 29.61, 33.56 +/- 17.32, and 23.58 +/- 13.57 ng/mL respectively and those of the three HIE subgroups on the 26-28th days after birth were 89.26 +/- 48.65, 71.46 +/- 38.35, and 54.39 +/- 26.39 ng/mL respectively. The serum IGF-I levels of HIE neonates at both acute and convalescence stages were significantly lower than those of the control group (71.23 +/- 35.42 and 96.54 +/- 52.38 ng/mL respectively; both P < 0.01), and associated with the severity of HIE as well as NBNA scores. GH levels were not significantly correlated to the severity of HIE and NBNA scores.

CONCLUSIONSSerum IGF-I levels can be used as a marker for estimating the severity and the outcome of neonatal HIE.

Human Growth Hormone ; blood ; Humans ; Hypoxia-Ischemia, Brain ; blood ; physiopathology ; Infant, Newborn ; Insulin-Like Growth Factor I ; analysis

PURPOSE: From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. METHODS: Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. RESULTS: Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. CONCLUSION: The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.
Caregivers ; Child ; Cost-Benefit Analysis ; Gross Domestic Product ; Growth Hormone ; Human Growth Hormone ; Humans ; Korea ; Quality of Life ; Quality-Adjusted Life Years ; Surveys and Questionnaires

PURPOSE: From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. METHODS: Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. RESULTS: Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. CONCLUSION: The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.
Caregivers ; Child ; Cost-Benefit Analysis ; Gross Domestic Product ; Growth Hormone ; Human Growth Hormone ; Humans ; Korea ; Quality of Life ; Quality-Adjusted Life Years ; Surveys and Questionnaires

For the present, to determine growth hormone(GH) deficiency in patients with short stature, many provocative tests using various pharmacological agents such as glucagon, insulin, clonidine, arginine, growth hormone releasing factor, etc. should be done. These are not only complicated but are also misleading in some patients. In search of a simple and accurate method of detecting GH deficiency that may replace the more complicated provocative tests, we measured basal plasma insulin-like growth factor-I (IGF-I) to see the correlation with the peak GH values in the GH stimulation test. But, in each group of patients with different types of short stature, IGF-I values were poorly correlated. In addition, IGF-I values of the patients with short stature compared to the age- and sex-matched normal ranges showed a significant overlap, and the difference between the proportion of patients with subnormal values in GH deficient patients and non-GH deficient patients was not prominent. Nevertheless, in response to human growth hormone (hGH) administration, both the yearly growth rate and IGF-I levels increased conspicuously. Therefore, even though it may not be feasible to use IGF-I as a single diagnostic measure of patients with short stature, the change in IGF-I values in the follow up of hGH therapy may well represent the response to hGH.
Adolescent ; *Body Height ; Child ; Child, Preschool ; Female ; Growth Disorders/*blood/diagnosis ; Growth Hormone/blood/*deficiency ; Human ; Insulin-Like Growth Factor I/*analysis/metabolism ; Male ; Somatomedins/*analysis

For the present, to determine growth hormone(GH) deficiency in patients with short stature, many provocative tests using various pharmacological agents such as glucagon, insulin, clonidine, arginine, growth hormone releasing factor, etc. should be done. These are not only complicated but are also misleading in some patients. In search of a simple and accurate method of detecting GH deficiency that may replace the more complicated provocative tests, we measured basal plasma insulin-like growth factor-I (IGF-I) to see the correlation with the peak GH values in the GH stimulation test. But, in each group of patients with different types of short stature, IGF-I values were poorly correlated. In addition, IGF-I values of the patients with short stature compared to the age- and sex-matched normal ranges showed a significant overlap, and the difference between the proportion of patients with subnormal values in GH deficient patients and non-GH deficient patients was not prominent. Nevertheless, in response to human growth hormone (hGH) administration, both the yearly growth rate and IGF-I levels increased conspicuously. Therefore, even though it may not be feasible to use IGF-I as a single diagnostic measure of patients with short stature, the change in IGF-I values in the follow up of hGH therapy may well represent the response to hGH.
Adolescent ; *Body Height ; Child ; Child, Preschool ; Female ; Growth Disorders/*blood/diagnosis ; Growth Hormone/blood/*deficiency ; Human ; Insulin-Like Growth Factor I/*analysis/metabolism ; Male ; Somatomedins/*analysis

OBJECTIVETo investigate the levels of insulin-like growth factor-1(IGF-1), insulin (INS)and growth hormone (GH) in the cord blood of neonates with intrauterine growth retardation (IUGR), and to assess the effects of the endocrine environment on IUGR.

METHODSSixty-three newborn infants were selected, including 37 males and 26 females. According to birth weight, they were classified into IUGR group (n=33) and control group (normal birth weight, n=30). The levels of IGF-1, INS and GH in the cord blood were measured.

RESULTSUmbilical cord serum levels of IGF-1 and INS in the IUGR group were significantly lower than those in the control group. In contrast, umbilical cord serum GH levels in the IUGR group were significantly higher than those in the control group. Birth weight was positively correlated with umbilical cord serum IGF-1 levels (r=0.625, P<0.01) and negatively correlated with GH levels (r=-0.257, P<0.05). Gestational age was positively correlated with umbilical cord serum IGF-1 levels (r=0.271, P<0.05). Multiple linear stepwise regression analysis showed that umbilical cord serum IGF-1 and INS levels were significant influential factors for birth weight.

CONCLUSIONSThe endocrine environment controls the growth and development of the fetus. The levels of IGF-1 and INS in the cord blood are associated with fetal weight. The low umbilical cord serum levels of IGF-1 may be one of the reasons for resulting in IUGR.

Female ; Fetal Blood ; chemistry ; Fetal Growth Retardation ; blood ; Human Growth Hormone ; blood ; Humans ; Infant, Newborn ; Insulin ; blood ; Insulin-Like Growth Factor I ; analysis ; Male ; Regression Analysis

Child ; Child, Preschool ; Female ; Growth Disorders ; blood ; diagnosis ; Human Growth Hormone ; deficiency ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; blood ; Insulin-Like Growth Factor I ; analysis ; Male

Adolescent ; Body Height ; drug effects ; Child ; Female ; Growth Disorders ; drug therapy ; Human Growth Hormone ; therapeutic use ; Humans ; Insulin-Like Growth Factor I ; analysis ; Male ; Recombinant Proteins ; therapeutic use

OBJECTIVETo study the expression of perforin and granzyme B (GzmB) in the lungs of asthmatic rats and the effect of recombinant human growth hormone (rhGH) on the expression.

METHODSThirty Sprague-Dawley male rats were randomly divided into a normal control group and asthma groups with and without rhGH treatment. An asthma model was prepared by repeated sensitization with ovalbumin and aluminium hydroxide. The morphological changes of the airway were observed by hematoxylin and eosin staining. Terminal deoxyribonucleotide transferase-mediated Dutp-bintin (TUNLE) was used to detect the apoptosis of epithelial cells in the airway. RT-PCR was used to detect the mRNA transcripts of perforin and GzmB in the lung tissues.

RESULTSA significantly increased apoptosis rate of airway epithelial cells was noted in the untreated asthma group. The apoptosis rate was significantly ruduced in the rhGH-treated asthma group (P<0.05). Compared with the control group, perforin and GzmB expression in the lungs in the untreated asthma group increased significantly. The rhGH-treated asthma group demonstrated significantly decreased perforin (0.48 ± 0.08 vs 0.63 ± 0.08; P<0.05) and GzmB (0.44 ± 0.13 vs 0.71 ± 0.15; P<0.05) expression in the lungs compared with the untreated asthma group. Both PFP (r=0.800, P<0.05) and GzmB (r=0.806, P<0.01) were positively correlated with the apoptosis rate of airway epithelial cells.

CONCLUSIONSPerforin and GzmB may play important roles in the pathogenesis of asthma. rhGH treatment can inhibit apoptosis of airway epithelial cells and airway remodeling, possibly through a reduction in perforin and GzmB expression.

Animals ; Apoptosis ; Asthma ; metabolism ; Bronchi ; pathology ; Granzymes ; analysis ; genetics ; Human Growth Hormone ; pharmacology ; Male ; Pore Forming Cytotoxic Proteins ; analysis ; genetics ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the effects of recombinant human growth hormone (r-hGH) replacement therapy on glucose and lipid metabolism and thyroid function in children with idiopathic short stature (ISS).

METHODSForty-seven ISS children with a mean age of 10±3 years treated between January 2009 and January 2013 were enrolled. All children underwent r-hGH replacement therapy for 3-24 months and were followed up once every 3 months. Fasting blood glucose (FBG), insulin (INS), blood lipids and thyroid function were measured before treatment and after 0-1 and 1-2 years of treatment.

RESULTSAfter treatment with r-hGH, there were no significant changes in FBG, INS, insulin sensitivity index (ISI), and FBG/INS ratio (FGIR), but the FGIR showed a declining trend. The percentage of patients with FGIR<7 (a marker of insulin resistance) was 13% before treatment compared to 18% 1-2 years after treatment. The atherosclerosis index decreased after r-hGH treatment, but there were no significant changes in total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and BMI. Furthermore, no significant change in thyroid function was observed after r-hGH therapy.

CONCLUSIONSr-hGH therapy can improve lipid metabolism, without significant impacts on thyroid function, FBG and INS. It seems to be a safe and reliable therapy for children with ISS. However, this therapy possibly reduces insulin sensitivity.

Adolescent ; Blood Glucose ; analysis ; Child ; Child, Preschool ; Female ; Glucose ; metabolism ; Growth Disorders ; drug therapy ; physiopathology ; Hormone Replacement Therapy ; Human Growth Hormone ; therapeutic use ; Humans ; Insulin ; blood ; Lipid Metabolism ; drug effects ; Male ; Thyroid Gland ; drug effects ; physiopathology