scholarly journals Psycho-Emotional and Behavioral Problems in Children With Growth Hormone Deficiency

2021 ◽  
Vol 9 ◽  
Author(s):  
Mykola Aryayev ◽  
Liudmyla Senkivska ◽  
John B. Lowe

Objective: To identify psychosocial problems and self-esteem in children with growth hormone deficiency (GHD) and define the role of some clinical and sociodemographic determinants in the conceptualization of internalizing and externalizing problems as criteria for psychosocial functioning.Materials and Methods: A GHD sample (46 prepubescent children) was selected and compared to a matched control group (80 healthy children). Psychosocial functioning in children with GHD was investigated using Goodman's “Strengths and Difficulties Questionnaire (SDQ).” The study of children's self-esteem was carried out by the Dembo–Rubinstein method.Results: This study reveals that the GHD sample has more internalizing problems and lower self-esteem. Higher score and frequency of assessment in the abnormal score for “total difficulties,” “emotional problem,” and “peer problem” were found in children with GHD. The SDQ score and the frequency of assessment in the abnormal score for all SDQ scales in children with more pronounced growth deficit (height SDS < −3) did not exceed the same indicators in children with less growth retardation (−3 < height SDS < −2). A comparison of psychosocial features in children with isolated growth hormone deficiency and multiple pituitary hormones deficiency did not reveal differences in SDQ score and the frequency of assessment in the abnormal score for all SDQ scales. It was found that children with GHD have a reduced level of assertions, low self-esteem, and a weak discrepancy between the level of assertions and self-esteem. Some sociodemographic determinants (male gender, age < 9 years, and low family income) and clinical determinants (low compliance and suboptimal growth response after 1 year of rGHh therapy) have an impact on the overall assessment of psychological problems in children with GHD. The internalizing difficulties are associated with certain clinical determinants (growth status and treatment status) and sociodemographic determinants (female gender, age < 9 years).Conclusions: The identification of low self-esteem and the high SDQ score for scales “total difficulties,” “emotional problems,” and “peer problems” indicates psychosocial maladjustment and conceptualization of internalizing problems in children with GHD.

2017 ◽  
Vol 62 (6) ◽  
pp. 4-9
Author(s):  
Maria S. Pankratova ◽  
Alexander I. Yusipovich ◽  
Maria V. Vorontsova ◽  
Tila T. Knyazeva ◽  
Adil A. Baizhumanov ◽  
...  

Objective and hypotheses. This study aimed at examining the effect of oxidative stress on amount and composition of major plasma carotenoids in prepubertal children with growth hormone deficiency (GHD).Material and methods. Thirteen prepubertal treatment-naive children (2 girls, 11 boys; aged 3.5—12.0 yr, median 8.0 years; bone age 1.5—8.0 yr; median 6.0 years,) with GHD and 7 prepubertal health children (7 boys; aged 6—11 years; median 9.3 years) were included in the study. The levels and composition of carotenoids (lutein with zeaxanthin, lycopene isomers, β-cryptoxanthin, β- and α-carotene and ketocarotenoids) were measured using reverse phase HPLC. Activity of the antioxidant system was assayed via thiobarbituric acid reactive substances (TBARS), ceruloplasmin (CP) levels and total antioxidant capacity (TAC) of plasma. Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were also measured.Results. The levels of TBARS, TC and LDL-C in the GHD children were higher than in healthy children (median 5.6 vs 3.8 µM/L, 4.00 vs 4.37 and 2.40 vs 2.70 mM/L, respectively). Total carotenoid level did not significantly differ between control and the GHD groups. However, contents of lutein and β-cryptoxanthin were significantly lower in the GHD children in comparison with control group (21.34 vs 6.97 and 25.23 vs 10.08 mg/l, respectively). In contrast, levels of lycopene, α- and β-carotene did not significantly differ in the GHD and control groups. At the same time, the level of ketocarotenoids in the GHD children increases (35.67 vs 114.9 mg/l).Conclusions. We observed that the presence of mild oxidative stress leads to a changes in carotenoid profile of GHD children.


2021 ◽  
Vol 77 (3) ◽  
pp. 7-13
Author(s):  
Mykola Aryayev ◽  
Liudmyla Senkivska

The work is devoted to assessing the quality of life (QоL) of children with growth hormone deficiency (GHD)  and  determining the correlation between the QoL and clinical, psycho-emotional and socio-demographic factors. A prospective observational cohort study was carried out at the «Odessa Regional Children's Clinical Hospital» among 46 prepubertal children with GHD and 80 healthy children matched for sex and age. The QоL was determined using Peds QL4.0 questionnaires, which were completed by children and their parents. Total psycho-emotional problems, internalizing and externalizing problems were investigated using 2-factor model of the «Strengths and Difficulties Questionaire (SDQ)», which was completed by the child's parents. The indices of the Peds QL4.0 and SDQ scale were fixed at baseline (T0) and after 12 months (T12) therapy with recombinant human growth hormone (rHGH) at an average dose of 0.033 mg/kg/day. The difference between the observed means ± SD in two independent samples were assessed using t-tests and «p» values. The relationship between clinical, psychological, socio-demographic factors and QoL of children with GHD was assessed by the calculation of Spearman’s correlation coefficient (rs).It was found that GHD was the cause for the decrease in the QoLaccording to the «total score» of the Peds QL4.0 scale for children and acccording to the subscales «physical health», «psychosocial health», «emotional functioning», «social functioning», «school functioning». The overall assessment in the SDQ «total difficulties» score increased and the conceptualization of internalizing problems occurred in children with GHD. The 12-months rHGH therapy contributes to the improvement of QoL in children with GHD, the normalization of the psycho-emotional state and the decrease in SDQ «total difficulties» and in «internalizing problems» scores.


2017 ◽  
Vol 45 (6) ◽  
pp. 1708-1719 ◽  
Author(s):  
S Gonzalez ◽  
JD Windram ◽  
T Sathyapalan ◽  
Z Javed ◽  
AL Clark ◽  
...  

Objective Epidemiological studies suggest that adult-onset growth hormone deficiency (AGHD) might increase the risk of death from cardiovascular causes. Methods This was a 6-month double-blind, placebo-controlled, randomised, cross-over trial followed by a 6-month open-label phase. Seventeen patients with AGHD received either recombinant human growth hormone (rGH) (0.4 mg injection daily) or placebo for 12 weeks, underwent washout for 2 weeks, and were then crossed over to the alternative treatment for a further 12 weeks. Cardiac magnetic resonance imaging, echocardiography, and cardiopulmonary exercise testing were performed at baseline, 12 weeks, 26 weeks, and the end of the open phase (12 months). The results were compared with those of 16 age- and sex-matched control subjects. Results At baseline, patients with AGHD had a significantly higher systolic blood pressure, ejection fraction, and left ventricular mass than the control group, even when corrected for body surface area. Treatment with rGH normalised the insulin-like growth factor 1 concentration without an effect on exercise capacity, cardiac structure, or cardiac function. Conclusion Administration of rGH therapy for 6 to 9 months failed to normalise the functional and structural cardiac differences observed in patients with AGHD when compared with a control group.


2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Héla Ayadi ◽  
Leila Cherif ◽  
Imen Hadjkacem ◽  
Wiem Kammoun ◽  
Khaoula Khemakhem ◽  
...  

1992 ◽  
Vol 127 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Zvi Laron ◽  
Anne-Maria Suikkari ◽  
Beatrice Klinger ◽  
Aviva Silbergeld ◽  
Athalia Pertzelan ◽  
...  

Insulin-like growth factors (IGFs) mediate the effects of growth hormone (GH), and the insulin-like growth factor-binding proteins (IGFBPs) modulate the actions of IGFs in tissues. We studied the circulating levels of IGFBP-1 in 6 children and 9 adults with Laron type dwarfism (LTD), in 11 children and 21 adults with growth hormone deficiency (GHD), and in 8 children with constitutional short stature. Compared with the situation in healthy children, the basal serum IGFBP-1 concentration was 5.4-fold higher in LTD children, 4.1-fold higher in GHD children, and 3.8-fold higher in children with short stature (p<0.02 vs controls in all groups). In adult patients with multiple pituitary hormone deficiency (MPHD), the IGFBP-1 concentration was 2-fold elevated, but it was normal in adult LTD patients. Intravenous (N= 10) or subcutaneous (N=9) administration ofIGF-I (75 μg·kg−1 and 150 μg·kg−1, respectively) in LTD children resulted in a rapid 50–60% fall in serum insulin (p<0.02), a decline in blood glucose and a concomitant 40–60% rise of IGFBP-1 levels (p<0.05). Treatment for seven days with IGF-I (150 μg·kg−1·d−1) resulted in a decrease by 34% and 44% of serum IGFBP-1 level in two out of three children with LTD. After prolonged GH therapy, the IGFBP-1 level fell in GHD children by 29% (p<0.05), in GHD adults by 52% (p<0.02) and in children with constitutional short stature by 17% (p<0.02). IGFBP-1 and insulin concentrations were inversely related in patients with GHD (r= −0.66, p<0.001) or with LTD (r= −0.57, p<0.05). Our data suggest that: (a) increased IGFBP-1 concentration in LTD, GHD and constitutional short children may, at least in part, be accounted for by an IGF-I deficiency; (b) both the rise in IGF-I and a fall in insulin contributed to the rise in IGFBP-1 after acute IGF-I administration; (c) prolonged IGF-I or GH treatment causes a persistent decline in IGFBP-1 concentration. In conclusion, IGF-I and GH may regulate IGFBP-1 secretion either directly or via insulin.


1985 ◽  
Vol 110 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Susan M. Webb ◽  
John A. H. Wass ◽  
Erica Penman ◽  
M. Murphy ◽  
José Serrano ◽  
...  

Abstract. Plasma immunoreactive somatostatin (IRS) levels were measured fasting at 09.00 h in groups of adult individuals and children of different ages, as well as in pregnant women, in patients with pernicious anaemia documented to be achlorhydric, and in children with growth hormone deficiency. There was a gradual rise in the mean level of IRS from the third decade (mean 35.8 ± 3.8 pg/ml), which reached significance at the seventh (61.1 ± 8.4 pg/ml), eighth (66.7 ± 5 pg/ml) and ninth decade (82.6 ± 13.8 pg/ml). No change was observed in the second 28.3 ± 3.8 pg/ml) and third (31.1 ± 3.2 pg/ml) trimester of pregnancy when compared with matched, non-pregnant controls (29.7 ± 2.2 pg/ml); however, the children aged under 2 years (69.6 ± 11.2 pg/ml) had significantly higher values than the eldest group (12 to 16 years old) (46.3 ± 7.2 pg/ml) (P < 0.05). In achlorhydric patients, basal (27.2 ± 3.7 pg/ml; P < 0.01) and postprandial IRS (42.8 ± 7.7 pg/ml; P < 0.001) was significantly lower than in a matched, normal control group (basal 59.4 ± 7.2; postprandial 132.1 ± 26.3 pg/ml). Growth hormone deficiency was not associated with any differences in circulating IRS, basally or after insulin hypoglycaemia, when compared with values in normal children. These results would suggest, 1) that age has a significant effect on plasma IRS, and should be considered in the interpretation of fasting plasma levels of IRS; 2) that pregnancy and growth hormone deficiency is not accompanied by any changes in circulating IRS and presumably, somatostatin binding proteins; 3) that gastric acid is necessary for a normal release of IRS from the gastrointestinal tract to the circulation.


1994 ◽  
Vol 40 (4) ◽  
pp. 65-81
Author(s):  
М. Bengt-Ake Bengtsson

Growth hormone deficiency (GH) for a long time was recognized only in childhood. Compelling evidence has been obtained showing that HR replacement therapy effectively stimulates growth and, in many cases, achieves normal end-points of physical development. More recently, it was shown that the most effective in this regard was the appointment of regular evening injections of the drug, which mimic the physiological secretion of GH during sleep. Despite the fact that the acceleration of linear growth is the most objective criterion for the effectiveness of therapy for GH, it is known that GH has a significant effect on body structure, causing a decrease in fat mass and an increase in muscle mass. Until recently, GH was not considered an important hormonal regulator in adults, and therefore, there was no study of GH deficiency and treatment of children with GH deficiency when they reached adulthood, as well as patients with hypopituitarism who became ill in adulthood. However, in 1989, as a result of two double-blind trials using placebo in the control group, the effectiveness of GH replacement therapy in adults with an abnormally low level of GH, up to a severe degree of GH deficiency, was revealed. Further studies showed the presence of violations of both physical and mental status in adults in whom GH deficiency develops as a result of the tumor process in the pituitary gland or its therapy. Most of these disorders, but not all, can be corrected as a result of GH replacement therapy, which confirms the significant effect of GH throughout life.


2019 ◽  
Vol 17 ◽  
pp. 205873921882423
Author(s):  
Yu Wang ◽  
Meng Sun ◽  
Xin Wang ◽  
Ya-Ying Cheng

This study aims to investigate the effects of recombinant human growth hormone (rhGH) on serum nesfatin-1 and ghrelin in children with growth hormone deficiency (GHD), in order to provide a reliable basis for the effectiveness and safety of applying rhGH in treating GHD children in the clinic. A total of 30 GHD pediatric patients were selected as the observation group. According to the peak of GH, these patients were divided into two subgroups: complete absence of growth hormone (CGHD) group and partial absence of growth hormone (PGHD) group. At the same time, 20 healthy children of normal height with matching age and gender were randomly selected as a normal control group. Serum ghrelin and nesfatin-1 levels were detected in children in the control group and observation group before rhGH treatment, and at 3 and 6 months after treatment. After 3 and 6 months of treatment, the height and growth rate of children in the PGHD and CGHD groups significantly increased ( P < 0.05), but their body weights did not significantly change ( P > 0.05), compared with those before treatment. Before treatment, ghrelin was higher in the PGHD group than in the control group, while ghrelin was lower in the CGHD group than in the control group. In addition, nesfatin-1 was higher in these two subgroups, compared with that in the control group. At pretreatment, and after 3  and 6 months of treatment, ghrelin and nesfatin-1 both decreased in the PGHD group, while ghrelin increased and nesfatin-1 decreased in the CGHD group. It was confirmed that ghrelin and nesfatin-1 were closely correlated with GHD. Furthermore, rhGH has a significant effect on children with GHD, and can significantly accelerate the annual growth rate.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Renata Stawerska ◽  
Joanna Smyczyńska ◽  
Maciej Hilczer ◽  
Andrzej Lewiński

Background. Some, however not all, children with growth hormone deficiency (GHD) reveal a tendency towards metabolic disorders. Insulin-like growth factor I (IGF-I) is the main mediator of GH anabolic effects. Objective. The aim of the study was to compare ghrelin, adiponectin, leptin, resistin, lipid, glucose, and insulin concentrations in GHD children, depending on the IGF-I bioavailability. Methods. The analysis comprised 26 children with GHD, aged 5.7–15.3 yrs. Fasting serum concentrations of IGF-I, IGFBP-3, ghrelin, leptin, adiponectin, resistin, lipids, glucose, and insulin were measured. The GHD children were divided into two subgroups: (1) with lower IGF-I/IGFBP-3 molar ratio and (2) with higher IGF-I/IGFBP-3 molar ratio. The control group consisted of 39 healthy children, aged 5.1–16.6 yrs, of normal height and body mass. Results. GHD children with lower IGF-I/IGFBP-3 molar ratio were found to have a significantly lower body mass and insulin and triglyceride concentrations, as well as significantly higher ghrelin and adiponectin concentrations than GHD children with higher IGF-I/IGFBP-3. Conclusions. A better metabolic profile characterised GHD children with low IGF-I bioavailability. This phenomenon may be the result of high adiponectin and ghrelin concentrations in those children and their influence on adipose tissue, glucose uptake, and orexigenic axis.


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