Abstract
PurposeThe effects of growth hormone (GH) treatment on linear growth and body composition have been studied extensively. Little is known about the GH effect on energy expenditure (EE). The aim of this study was to investigate the effects of GH treatment on EE in children, and to study whether the changes in EE can predict the height gain after 1 year.MethodsTotal EE (TEE), basal metabolic rate (BMR), and physical activity level (PAL) measurements before and after 6 weeks of GH treatment were performed in 18 prepubertal children (5 girls, 13 boys) born small for gestational age (n = 14) or with growth hormone deficiency (n = 4) who were eligible for GH treatment. TEE was measured with the doubly labelled water method, BMR was measured with an open-circuit ventilated hood system, PAL was assessed using an accelerometer for movement registration and calculated (PAL = TEE/BMR), activity related EE (AEE) was calculated [AEE = (0.9 × TEE) − BMR]. Height measurements at start and after 1 year of GH treatment were analysed. This is a 1-year longitudinal intervention study, without a control group for comparison.ResultsBMR and TEE increased significantly (resp. 5% and 7%). Physical activity (counts/day), PAL, and AEE did not change. 11 out of 13 patients (85%) with an increased TEE after 6 weeks of GH treatment had a good first-year growth response (∆height SDS > 0.5).ConclusionsGH treatment showed a positive effect on EE in prepubertal children after 6 weeks. No effect on physical activity was observed. The increase in TEE appeared to be valuable for the prediction of good first-year growth responders to GH treatment.
Highlights
Already for many years, short children with growth hormone (GH) deficiency (GDH) and/or born small for gestational age (SGA) have been treated with recombinant human GH to promote their linear growth
The first aim of this study is to investigate the effects of GH on energy expenditure (BMR, Total daily energy expenditure (TEE) and activity related energy expenditure (AEE)) and body composition in prepubertal children
The second aim of this study is to investigate the relation of the GH induced changes in energy expenditure and the height gain after 1 year
Summary
Already for many years, short children with growth hormone (GH) deficiency (GDH) and/or born small for gestational age (SGA) have been treated with recombinant human GH to promote their linear growth. Beside its growth-promoting effect, GH has many specific metabolic effects as well, including (1) increased mobilization of fatty acids from adipose tissue and increased use of fatty acids for energy, (2) increased rate of protein synthesis in most cells of the body, and (3) decreased rate of glucose utilization throughout the body The effect of these changes in metabolism is reflected in a decrease in fat mass and an increase in fat free mass, as shown in several studies (Vaisman et al 1994, 1992; Gregory et al 1991, 1993; Ernst et al 2012; Khadilkar et al 2014; Walker et al 1990; Boot et al 1997; Hassan et al 1996).
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