Prevalence of growth hormone (GH) deficiency in previously GH-treated young adults with Prader-Willi syndrome.

Abstract

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.

• Authors: Stephany H Donze, Layla Damen, Janiëlle A E M van Alfen-van der Velden, Gianni Bocca, Martijn J J Finken, Gera J G Hoorweg-Nijman, Petr E Jira, Mariëtte van Leeuwen, Anita C S Hokken-Koelega
• Journal: Clinical endocrinology (Clin Endocrinol (Oxf)) Vol. 91 Issue 1 Pg. 118-123 (07 2019) ISSN: 1365-2265 [Electronic] England
• PMID: 30973645 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 The Authors. Clinical Endocrinology Published by John Wiley & Sons Ltd.

Chemical References

• IGFBP3 protein, human
• Insulin-Like Growth Factor Binding Protein 3
• Human Growth Hormone
• Insulin-Like Growth Factor I
• Growth Hormone

Topics

• Adult
• Body Mass Index
• Cross-Sectional Studies
• Dwarfism, Pituitary (blood, epidemiology, etiology)
• Female
• Growth Hormone (adverse effects, therapeutic use)
• Human Growth Hormone (blood)
• Humans
• Insulin-Like Growth Factor Binding Protein 3 (blood)
• Insulin-Like Growth Factor I (metabolism)
• Male
• Prader-Willi Syndrome (blood, drug therapy)
• Prevalence
• Young Adult