Abstract
Introduction. Bone mineral accretion continues beyond the attainment of final height during the transition period. Growth hormone deficiency (GHD) appears to have a significant effect on collagen turnover during childhood and less during adulthood. Amino-terminal pro-peptide of type I collagen (P1NP) is a marker of bone formation with low intra-individual when comparing to IGF1. Material and method. We evaluated 17 male patients diagnosed with GHD during childhood, after retesting GH axis in their transition period after at least 3 months from GH withdrawal. We correlate concentrations of P1NP and IGF1. We determined the predictive value for P1NP in identifying persistent GHD. Results. We found a strong positive correlation between IGF-1 and P1NP in the group of patients who maintained GH deficiency as young adults (r = 0.72, CI [0.02 to 0.94], p = 0.046). A threshold value for the P1NP of - 0.66 SDS predicts persistence of GHD with a sensitivity of 62.5% CI [24.5 to 91.5], specificity 75% CI [47.6 to 92.7] and AUC = 0.719 CI [0.5 0881]. We did not find a significant difference when we compared the AUC for the two parameters (p = 0.29). Conclusion. During the transition period, when the growth velocity is not available anymore, the dynamics of P1NP may be useful in quantifying the effectiveness of GH replacement therapy.
Highlights
Bone mineral accretion continues beyond the attainment of final height during the transition period
IGF1 has been extensively used in clinical settings as a screening test for Growth hormone (GH) deficiency (GHD), his coefficient of reliability is lower than that of the collagen markers [5]
We evaluated seventeen male patients with GH (4 multiple pituitary hormone deficiency (MPHD)), mean age 17.3 years, treated during their childhood with recombinant GH for an average period of 6.88 years, after a minimum period of 3 months from the discontinuation of GH
Summary
Bone mineral accretion continues beyond the attainment of final height during the transition period. Growth hormone deficiency (GHD) appears to have a significant effect on collagen turnover during childhood and less during adulthood. Amino-terminal propeptide of type I collagen (P1NP) is a marker of bone formation with low intra-individual when comparing to IGF1. We determined the predictive value for P1NP in identifying persistent GHD. Bone mineral accretion continues beyond the attainment of final height during the transition that is defined as the period elapsed since the achievement of final height and the somatic development to complete. IGF1 has been extensively used in clinical settings as a screening test for GH deficiency (GHD), his coefficient of reliability is lower than that of the collagen markers [5]. Serum surrogate markers of collagen synthesis allow the assessment of bone formation [7,8]
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