Background:Eutropin is a recombinant human growth hormone preparation and has been used in patients with growth hormone deficiency. Short stature is a characteristic feature of Turner syndrome, which is caused by sexual chromosomal anomalies. Growth hormone therapy would increase growth velocity and increase the ultimate final height in patients with Turner syndrome. The purpose of this study was to evaluate the clinical effects and safety in patients with Turner syndrome with Eutropin treatment. Subjects and METHODS:60 patients with Turner syndrome,who were diagnosed by chromosome study,were treated with Eutropin 1IU/kg/week for 12 months and followed up every 3 month. The height and weight were evaluate at 0, 3, 6, 9, 12 months. A complete blood count, ESR, urinary analysis and chemistry studies were done every 3 month. IGF- I , T4, TSH & anti-GH antibody were measured at 6 months and 12 months. Chest X-ray was checked at 0, 6 ,12 months. RESULTS:60 patients were enrolled but 10 patients were lost or treated irregularly and excluded in the study of growth effect. but included all cases in safety analysis. At the onset of Eutropin therapy,their mean age was 10.8+/-2.9 years old(range 4.2- 14.9yr)and the height was 121.1+/-13.7cm(-3.1+/-0.9 SDS) and yearly growth velociy was 3.4+/-1.5cm. Their weight was 30.5+/-10.6kg and bone age 9.1+/-3.0 yrs. After Eutropin treatment, mean height was increased to 123.2+/-13.5cm at 3 months, 125.2+/-13.1cm at 6 months, 127.5+/-12.4cm at 9 months, 128.3+/-12.8cm at 12 months. Height velocity were increased to 8.3+/-3.1cm at 3 months, 8.1+/-2.6cm at 6 months, 7.6+/-1.9cm at 9 months and 7.1+/-1.9cm at 12 months(P<0.001). Height SDS at 0, 3, 6, 9, 12 months were -3.1+/-0.9, -2.9+/-1.0, -2.7+/-0.9, -2.7+/-0.9 respectively(P>0.001).Their bone age were 9.1+/-3.0yr, 9.6+/-2.9yr, 10.2+/-2.7yr before and 6 & 12 months after treatment respectively. HA/BA were 0.84+/-0.15, 0.87+/-0.13, 0.88+/-0.12 at before and 6 & 12 months after treatment respectively(P<0.05). Growth velocity of 4-8 yrs group was most prominent compared to other groups. Serum IGF- I concentration was increased from 167.4+/-85.8ng/ml to 368.4+/-158.1ng/ml at 6 months and 423.2+/-181.0ng/ml at 12 month(P<0.001) after treatment. No significant changes were observed in thyroid function, CBC, ESR, Blood chemistry and urinalysis. Anti-hGH antibody were positive in 2 patients, but these didnot attenualte the growth velocity. CONCLUSION: Treatment with Eutropin increased significantly height velocity in patients with Turner syndrome. No specific adverse events were observed during Eutropin therapy.
Blood Cell Count ; Chemistry ; Growth Hormone ; Human Growth Hormone ; Humans* ; Thorax ; Thyroid Gland ; Turner Syndrome* ; Urinalysis

PURPOSE: For evaluation of the growth hormone and cortisol responses to insulin stimuli in children with short stature, the human growth hormone secretion and cortisol level was monitored 30 and 60 minutes after insulin infusion by intravenousely. METHODS: The inclusion criteria of children for this study were that the height was below 3 percentile compare with the same sex and age children, bone age was younger more than one year of chronologic age, and insulin and L-dopa induced growth hormone secretion was below 10ng/mL. There were 10 children compatible with this criteria(group A) and 11 children was selected for control group(group B). Serum concentration of growth hormone was determined just before intravenous infusion of 0.1U/kg insulin and then 30 and 60 minutes after insulin infusion. Serum level of cortisol was determined simultaneously with the growth hormone but skip the level of the 30 minutes after insulin infusion. Serum glucose level was monitored on every time sampling the blood for determined growth hormone and cortisol level. Serum level of growth hormone and cortisol were determined by radioimmunoassay. RESULTS :The serum glucose concentration were decrease to under 50% of baseline level on 30 minutes after insulin infusion in A and B group. The serum growth hormone level before insulin infusion was 2.5+/-1.78ng/mL and changed to 2.2+/-1.69 ng/mL on 60 minutes after insulin infusion in group A. In group B, the serum growth hormone level alteration before and on 60 minutes after insulin infusion was from 5.5+/-6.67ng/mL to 12.6+/-7.91ng/mL. The serum concentration of cortisol was changed from baseline level 10.7+/-7.10, 7.9+/-3.98microg/dL to 16.7+/-11.47, 26.1+/-3.59microg/ dL on 60 minutes after insulin infusion in group A and B respectively, but some cases in group A show a little increase in cortisol level. CONCLUSION: On the basis of this study, it is suggested that the deficiency of growth hormone secretion is related to cortisol concentration in peripheral blood. But for more detailed assessment of this association, follow up studies will be needed in more cases.
Blood Glucose ; Child* ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hydrocortisone* ; Infusions, Intravenous ; Insulin* ; Levodopa ; Radioimmunoassay

OBJECTIVETo investigate the levels and roles of serum growth hormone (GH) and prolactin (PRL) in neonatal hypoxic-ischemic encephalopathy (HIE).

METHODSSerum GH and PRL levels were measured by radioimmunoassay in 54 neonates with HIE (20 mild, 19 moderate and 15 severe HIE) at the acute and convalescence stages. Twenty normal neonates were used as controls.

RESULTSSerum GH levels were significantly lower, but PRL levels were significantly higher in moderate and severe HIE neonates at the acute stage compared with those of controls and mild HIE neonates (P < 0.01). There were noticeable differences in serum levels of GH and PRL between the moderate and severe HIE cases (P < 0.01). During the convalescence stage, serum GH levels increased and PRL levels decreased in moderate and severe HIE neonates compared with those at the acute stage (P < 0.01); serum GH and PRL levels in each sub-group of HIE restored to the levels of controls. There was a closely negative correlation between GH and PRL levels at the acute stage of HIE (r = -0.8759, P < 0.01).

CONCLUSIONSGH and PRL might be involved in the pathophysiological process of HIE. The levels of GH and PRL closely relate to the severity of HIE at the acute stage.

Female ; Human Growth Hormone ; blood ; Humans ; Hypoxia-Ischemia, Brain ; blood ; Infant, Newborn ; Male ; Prolactin ; blood

PURPOSE: Growth retardation is one of the major side effects of chronic renal failure. In this study, the short-term growth promoting effect, effect on the chemical parameters, and probable side effects of growth hormone treatment to child patients with chronic renal failure were examined. METHODS: The research sample was 5 child patients diagnosed with chronic renal failure and receiving growth hormone treatement for more than 6 months. Data were gathered on the height standard deviation scores, IGF-I, fasting blood sugar, general chemistry changes, and changes in blood pressure. Collected data was processed as the statistics by SAS (ver 6.12) program. RESULTS: After six months of growth hormone treatment, three of 5 subjects showed clinical increase in height SDS. The rest two, who were older than 10, also showed steady growth, but significant differences didn't appear in the process of statistical analysis (P=0.0625). All of those three done IGF-I has shown clinical increases, but significant differences didn't appear in the process of statistical analysis (P=0.1079). Presumably, it was because of the small number of the subjects and the short period of observation. One of the five patients showed increased blood pressure after the treatment. However, even after stopping the treatment, the blood pressure didn't return to the normal level. CONCLUSION: Growth hormone treatment to child patients with low height caused by chronic renal failure induced growth effect in the clinical setting without pernicious side-effects or significant changes in the biochemical tests.
Blood Glucose ; Blood Pressure ; Chemistry ; Child* ; Fasting ; Growth Hormone ; Human Growth Hormone* ; Humans* ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic*

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

Body Height ; Child ; Female ; Ghrelin ; pharmacology ; Growth Disorders ; physiopathology ; Growth Hormone-Releasing Hormone ; pharmacology ; Human Growth Hormone ; blood ; physiology ; urine ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; blood ; Insulin-Like Growth Factor I ; physiology ; Male

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

OBJECTIVETo assess the diagnostic value of the propranolol-exercise provocative test for growth hormone deficiency (GHD) in children.

METHODSThis study included 120 children who received both the insulin provocative test and the propranolol-exercise provocative test due to short stature between January 2009 and March 2013. Growth hormone (GH) levels in venous blood were measured before and after the provocative test. Peak GH <10 ng/mL was defined as negative stimulation, while peak GH ≥10 ng/mL was defined as positive stimulation. The children whose peak GH levels were <10 ng/ mL after both tests were diagnosed with GHD.

RESULTSTwenty-nine (24.2%) of the 120 children with short stature were diagnosed with GHD. The positive rate in the insulin provocative test was 48.3%, versus 65.8% in the propranolol-exercise provocative test. The overall coincidence rate and positive coincidence rate of the two tests were 62.5% and 79.3%, respectively. The peak GH after the propranolol-exercise provocative test was significantly higher than that after the insulin provocative test (P<0.01). Peak GH occurred mostly at 30-60 minutes after the insulin provocative test, while that occurred mostly at 120 minutes after the propranolol-exercise provocative test. No adverse effects were observed in the propranolol-exercise provocative test.

CONCLUSIONSCoincidence rates in stimulating the secretion of GH are high between the propranolol-exercise provocative test and the insulin provocative test. Compared with the insulin provocative test, the propranolol-exercise provocative test is more likely to stimulate the secretion of GH. GHD can be clinically diagnosed by the insulin provocative test combined with the propranolol-exercise provocative test.

Adolescent ; Child ; Child, Preschool ; Exercise ; Female ; Human Growth Hormone ; blood ; deficiency ; Humans ; Insulin ; Male ; Propranolol

OBJECTIVETo explore the effect of transsphenoidal adenectomy on glucose tolerance status in patients with growth hormone (GH)-secreting pituitary adenoma.

METHODSThe clinical data of 105 patients with GH-secreting pituitary adenoma who underwent transsphenoidal adenectomy in our department in 2013 were retrospectively analyzed. The glucose tolerance status, GH level, and insulin-like growth factor-1 (IGF-1) level before and after surgery were compared.

RESULTSAmong these 105 patients, the blood glucose tolerance status included normal glucose tolerance (NGT) in 47 cases (44.8%), early carbohydrate metabolism disorders (ECMDs) in 26 cases (24.8%), and diabetes mellitus (DM) in 32 cases (30.5%) before surgery. After the surgery, the fasting blood glucose (P=0.006, P=0.017) and postprandial blood glucose (P=0.000, P=0.000) in the ECMDs and DM groups were significantly improved. Also, the random GH (P=0.001, P=0.004, P=0.001), nadir GH (P=0.000, P=0.001, P=0.001), and IGF-1 (P=0.005, P=0.000, P=0.000) significantly decreased during the follow-up period in NGT, ECMDs and DM groups. Compared with ECMDs and DM groups, the decrease in fasting blood glucose (P=0.029, P=0.000), postprandial blood glucose (P=0.003, P=0.000), and serum IGF-1 (P=0.048, P=0.000) were more significant in DM group.

CONCLUSIONSTranssphenoidal adenectomy can improve the blood glucose, GH, and IGF-1 levels in patients with growth hormone-secreting pituitary adenoma. Meanwhile,the surgery has a better effect in improving the glucose tolerance status and IGF-1 in patients with preoperatively confirmed DM.

Adenoma ; Blood Glucose ; Diabetes Mellitus ; Glucose ; Growth Hormone-Secreting Pituitary Adenoma ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Retrospective Studies

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