Growth Hormone Treatment Clinical Trial
Official title:
Evaluation of Adrenal Function Before and After GH Treatment in GHD Affected by GH Deficiency
To evaluate in children affected by idiopathic GHD the adrenal function both at baseline and after 6 and 12 months of GH treatment.
The relationship between the growth hormone (GH)-insulin like growth factor (IGF)-I system
and the hypothalamic-pituitary-adrenal (HPA) axis is complex and not univocal. Both a
stimulatory and neutral effect of IGF-I on HPA axis has been demonstrated in in vitro models
and in healthy subjects, respectively. The effect of GH on the 11beta-hydroxysteroid
dehydrogenases (11beta-HSD) isozymes is always to be considered in patients affected by GHD
both at diagnosis and during GH treatment. Indeed, in peripheral tissues, corticosteroid
hormone action is partially determined by the activity of 11beta-HSD, two isozymes of which
interconvert hormonally active cortisol and inactive cortisone. 11beta-HSD2 inactivates
cortisol to cortisone in the kidney, whilst 11beta-HSD1 performs the reverse reaction
activating cortisol from cortisone in the liver and adipose tissue.
For these reasons, many data are available about the evaluation of adrenal function in
patients affeceted byGHD, but most of them come from patients with organic GHD or adult
patients, while few and discordant data are available on pediatric GHD patients. We aimed to
evaluate, through insulin tolerance test, the adrenal function in about 30 children with
overt diagnosis of idiopathic GHD both at baseline and after 6 and 12 months of GH
treatment.
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