GH THERAPY IN NON GH DEFICIENT (NGHD) GIRLS: ITS EFFECT ON STEROID PLASMA LEVELS

Abstract

A number of studies have shown that GH may act directly or indirectly (via IGF1) at ovarian and adrenal levels thus increasing their steroidogenic activity. As GH therapy is now used also in short NGHD subjects, the aim of our study was to evaluate gonadal and adrenal plasma steroids in short NGHD patients treated with GH. Insulin was also measured as GH therapy in NGHD patients may cause hyperineulinemia, and because a relationship between hyperinsulinemia and hypeandrogenism exists. We evaluated the plasma steroid pattern in 10 NGHD short girls (stature −2.8 ± 0.6 SD; age improve their final height, these girls were treated with GH (Saizen 0.08-0.1 IU/Kg B.C. day for six days weekly) and, in order to delay epiphyseal closure, with GnRH analogue leuprolide (Enantone 3.75 mg every 25 days). Estradiol (E2), testosterone (T), androstenedione (A), 17α-hydroxyprogesterone (17OHP), deidroepiandrosterone sulphate (DHA-S), sex hormone binding globulin (SHBG) and insulin after OGTT were evaluated by RIA at the beginning and 6, 12, 18 months during therapy. We report the results at the beginning and at 18 months of therapy as mean ± SD. Plasma levels of E2 were lowered to prepubertal values at 6 months and remained stable at 12 and 18 months. Plasma levels of T, A, 17OHP, DHA-S did not show any significant change during the study (T: 24.7 ± 6.3 and 20 ± 11 ng/dl, A: 112 ± 29 and 121.4 ± 27.3 ng/dl, 17OHP: 70.4 ± 28 and 80 ± 18.2 ng/dl, DHA-S 102.5 ± 53.6 and 124.8 ± 74.8 ug/dl). Plasma levels of SHBG did not change (78.6 ± 25.6 and 80.2 ± 28.4 M). Insulin (uU/ml) basal levels and insulin peak after OGTT were 12.5 ± 3.5 and 78.9 ± 28.5, 10.3 ± 4.2 and 123.5 ± 60.7.