All issues > Volume 52(2); 2009

Original Article

Korean J Pediatr. 2009;52(2):227-233. Published online February 15, 2009.

Factors for persistent growth hormone deficiency in young adults with childhood onset growth hormone deficiency

Young Ah YA Lee¹, Hye Rim HR Chung¹, Se Min SM Lee², Jae Hyun JH Kim¹, Ji Hyun JH Kim¹, Sun Hee SH Lee¹, Choong Ho CH Shin¹, Sei Won SW Yang¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
²Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea

Correspondence Choong Ho CH Shin ,Email: chshinpd@snu.ac.kr

Abstract

Purpose
: Growth hormone (GH) replacement after retesting is necessary because impairment of body composition and cardiovascular health has been more severe in adult patients with persistent GH deficiency (GHD) from childhood to adulthood. This study aimed to investigate the factors for persistent GHD and define a highly probable group of persistent GHD in young adults with childhood-onset GHD.
Methods
: GHD was reassessed by insulin tolerance test (ITT) in 55 adult patients (39 males, 16 females) with childhood- onset GHD. Twelve patients presented with idiopathic GHD and 43 patients presented with organic GHD caused by tumors involving the hypothalamus-pituitary (H-P) region (n=33), other brain tumors (n=3), meningitis (n=3), leukemia (n=2) and others (n=2).
Results
: Forty-nine (89.1%) of 55 patients had persistent GHD. IGF-I was positively correlated with log of peak GH (r=0.57, P<0.001). There was no difference in the proportion of persistent GHD between idiopathic and organic GHD. The percentage of patients with persistent GHD was 40%, 80%, and 95.6% for patients with zero, one, two or more additional pituitary hormone deficiencies (PHDs), respectively (P=0.002). The probability of persistent GHD was higher in patients with diseases involving the H-P region (P=0.003). GHD persisted in 15 of 18 patients treated with cranial irradiation.
Conclusion
: We suggest that the probability of persistent GHD in adulthood was high in patients with 2 or more additional PHDs, and diseases involving the H-P region.

Keywords :Growth hormone deficiency, Insulin tolerance test, Adult, Child