Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

Background: Hypothyroidism in children leads to growth retardation. However, there is some evidence that recombinant human growth hormone (rhGH) therapy could suppress thyroid function. The most common observation in rhGH-treated patients is a decrease in thyroxine levels, which is reported as trans...

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Autores principales:	Ewelina Witkowska-Sędek, Anna Małgorzata Kucharska, Małgorzata Rumińska, Monika Paluchowska, Beata Pyrżak
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	thyroid function alterations growth hormone deficiency (GHD) recombinant human growth hormone (rhGH) therapy growth response children Medicine R
Acceso en línea:	https://doaj.org/article/14b34d554ed84f2a967ab5a2b812ae6d
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spelling	oai:doaj.org-article:14b34d554ed84f2a967ab5a2b812ae6d2021-11-11T17:43:12ZDecreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency10.3390/jcm102151002077-0383https://doaj.org/article/14b34d554ed84f2a967ab5a2b812ae6d2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5100https://doaj.org/toc/2077-0383Background: Hypothyroidism in children leads to growth retardation. However, there is some evidence that recombinant human growth hormone (rhGH) therapy could suppress thyroid function. The most common observation in rhGH-treated patients is a decrease in thyroxine levels, which is reported as transient, but the studies in the field are inconsistent. We aimed to evaluate thyroid function in initially euthyroid children with idiopathic isolated GH deficiency during long-term rhGH therapy and to determine who is at a higher risk of thyroid function alterations during the therapy. Methods: The study group consisted of 101 children treated with rhGH for at least three years. Serum TSH and fT4 levels were determined at baseline, after the first six months and after each full year of therapy. The associations between changes in thyroid hormone levels during rhGH therapy and GH deficit, insulin-like growth factor-1 levels and growth response were investigated. Results: A significant decrease in fT4 levels (<i>p</i> = 0.01) was found as early as after the first six months of rhGH therapy. This effect persisted in the subsequent years of treatment without any significant changes in TSH values and tended to be rhGH dose related. Children with a greater fT4 decrease after the initiation of rhGH therapy were older, had higher bone age and responded to that therapy worse than children with lower fT4 changes. Conclusions: Our study revealed a long-term decrease in fT4 levels during rhGH therapy in initially euthyroid GHD children. The decrease in fT4 levels was associated with a lower growth response to rhGH therapy.Ewelina Witkowska-SędekAnna Małgorzata KucharskaMałgorzata RumińskaMonika PaluchowskaBeata PyrżakMDPI AGarticlethyroid function alterationsgrowth hormone deficiency (GHD)recombinant human growth hormone (rhGH) therapygrowth responsechildrenMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5100, p 5100 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	thyroid function alterations growth hormone deficiency (GHD) recombinant human growth hormone (rhGH) therapy growth response children Medicine R
spellingShingle	thyroid function alterations growth hormone deficiency (GHD) recombinant human growth hormone (rhGH) therapy growth response children Medicine R Ewelina Witkowska-Sędek Anna Małgorzata Kucharska Małgorzata Rumińska Monika Paluchowska Beata Pyrżak Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
description	Background: Hypothyroidism in children leads to growth retardation. However, there is some evidence that recombinant human growth hormone (rhGH) therapy could suppress thyroid function. The most common observation in rhGH-treated patients is a decrease in thyroxine levels, which is reported as transient, but the studies in the field are inconsistent. We aimed to evaluate thyroid function in initially euthyroid children with idiopathic isolated GH deficiency during long-term rhGH therapy and to determine who is at a higher risk of thyroid function alterations during the therapy. Methods: The study group consisted of 101 children treated with rhGH for at least three years. Serum TSH and fT4 levels were determined at baseline, after the first six months and after each full year of therapy. The associations between changes in thyroid hormone levels during rhGH therapy and GH deficit, insulin-like growth factor-1 levels and growth response were investigated. Results: A significant decrease in fT4 levels (<i>p</i> = 0.01) was found as early as after the first six months of rhGH therapy. This effect persisted in the subsequent years of treatment without any significant changes in TSH values and tended to be rhGH dose related. Children with a greater fT4 decrease after the initiation of rhGH therapy were older, had higher bone age and responded to that therapy worse than children with lower fT4 changes. Conclusions: Our study revealed a long-term decrease in fT4 levels during rhGH therapy in initially euthyroid GHD children. The decrease in fT4 levels was associated with a lower growth response to rhGH therapy.
format	article
author	Ewelina Witkowska-Sędek Anna Małgorzata Kucharska Małgorzata Rumińska Monika Paluchowska Beata Pyrżak
author_facet	Ewelina Witkowska-Sędek Anna Małgorzata Kucharska Małgorzata Rumińska Monika Paluchowska Beata Pyrżak
author_sort	Ewelina Witkowska-Sędek
title	Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
title_short	Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
title_full	Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
title_fullStr	Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
title_full_unstemmed	Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency
title_sort	decreased thyroxine levels during rhgh therapy in children with growth hormone deficiency
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/14b34d554ed84f2a967ab5a2b812ae6d
work_keys_str_mv	AT ewelinawitkowskasedek decreasedthyroxinelevelsduringrhghtherapyinchildrenwithgrowthhormonedeficiency AT annamałgorzatakucharska decreasedthyroxinelevelsduringrhghtherapyinchildrenwithgrowthhormonedeficiency AT małgorzataruminska decreasedthyroxinelevelsduringrhghtherapyinchildrenwithgrowthhormonedeficiency AT monikapaluchowska decreasedthyroxinelevelsduringrhghtherapyinchildrenwithgrowthhormonedeficiency AT beatapyrzak decreasedthyroxinelevelsduringrhghtherapyinchildrenwithgrowthhormonedeficiency
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Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency

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