High Anxiety Levels and Growth Hormone Secretion in Children with Short Stature

Dror Nitsan,Eliakim Alon,Nemet Dan,Pantanowitz Michal

doi:10.36959/433/566

Abstract

Growth hormone (GH) provocation test, which includes repeated blood measurements following pharmacological stimuli, may be stressful for the children and their family. Thirty-three short stature children with impaired growth rate were studied during GH provocation tests to determine if the test is associated with increased anxiety and if increased anxiety affects the test results.

Highlights

Short stature is a major concern to many families and one of the leading causes for referral to pediatric endocrinology clinics [1]
The average anxiety state of the children was reduced by the end of the growth hormone (GH) provocation test compared to the beginning but was still in the moderate range (52.4 ± 12.3 vs. 46.3 ± 11.4 at the beginning and the end of the test, respectively; P = 0.02)
The present study examined the levels of anxiety during GH provocation test in children with short stature who were evaluated for GH deficiency, and assessed the effect of anxiety on GH secretion

Summary

Introduction

Short stature is a major concern to many families and one of the leading causes for referral to pediatric endocrinology clinics [1]. Since growth hormone (GH) secretion is pulsatile, the diagnosis of GH deficiency in children is challenging. GH provocation tests, which include repeated blood measurements following pharmacological stimuli, have been developed [2]. Two abnormal GH secretion tests are needed in order to diagnose GH deficiency. The test may be stressful for the children and their parents leading to activation of stress mechanisms. The central activation by the stress response leads to glucocorticoid (cortisol) and catecholamine (norepinephrine) release that shifts the metabolism toward catabolism [4]. The stress system result in adaptive endocrine and metabolic changes, major stress or chronic activation can have adverse effects such as insulin resistance, obesity, immune dysfunction, hypogonadism reduced GH secretion [4,5]

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