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Growth Hormone Benefits Children With Steroid-Dependent Inflammatory Bowel Disease

Concurrent recombinant human growth hormone seems to benefit children with inflammatory bowel disease and who are steroid dependent.

For this study, researchers from Nemours Children's Clinic, Jacksonville, Florida, and other American centres enrolled six boys and four girls with inflammatory bowel disease who had taken oral prednisone for at least four months. The children then also received subcutaneous recombinant human growth hormone (0.05 mg/ kg daily) for six months. Seven patients continued growth hormone for 12 months.

Pharmacia and Upjohn funded this study, in part.

Over four months treatment, fat-free mass increased by an average 3 kg. Meanwhile, fat mass declined by, on average, 3.5 percent.

Linear growth velocity increased from an average of 3.5 cm per year during prednisone treatment to 7.7 cm per year after six months treatment with concurrent growth hormone. The children who continued treatment for a year still showed increased growth velocity. Furthermore, growth hormone was associated with increased concentrations of plasma insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3).

Growth hormone did not alter calcium absorption. However, the rate of bone calcium accretion and bone-specific alkaline phosphatase concentrations both rose. The latter offers a measure of bone formation.

Whole body protein turnover, oxidation, synthesis as well as substrate oxidation, resting energy expenditure and Crohn's disease activity score did not change. Similarly, no changes emerged in fasting or two-hour postprandial glucose concentrations, fasting insulin levels, and HbA_1C.

The authors concluded that adding recombinant human growth hormone to corticosteroids in children with inflammatory bowel disease benefits body composition, bone metabolism, and linear growth, without undermining either carbohydrate tolerance or intermediate metabolism. They add that larger studies should assess the long-term safety and efficacy of recombinant human growth hormone in such patients.
Metabolism 2002;51:127-35. "Growth hormone has anabolic effects in glucocorticosteroid-dependent children with inflammatory bowel disease: A pilot study"

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