摘要:

While enhanced growth velocity is a well-established benefit following the initiation of growth hormone treatment (GHT), the potential benefit of GHT on quality of life (QOL) of short-stature children has not yet been documented. We compare QOL of two groups of short-stature children who attended the Endocrine Unit (EU) and were 2 SD or more below the average for age and gender. The first group included 96 patients of whom 65 were without any underlying disease, 15 had classical GH deficiency and 16 had Turner syndrome or renal disease. These patients were on GHT for at least 2 years. The other group included 33 patients. Owing to lack of resources to include these 33 patients in a clinical trial, they did not get GHT. They were normal variant of short stature, and their height was similar to the height of the 65 children included in the first group. QOL was assessed using self-administered questionnaires, which were filled out by the patients on their regular visit to the EU. QOL was defined in terms of school achievements, leisure activities, emotional and physical self-esteem, relationships with peers and family members. No significant differences were found between the two groups. The mean scores for the different domains of QOL ranged between 2.6 and 3.8 on a scale ranging from 1 (very pessimistic view) to 4 (very optimistic view).

ISSN:1663-2818    

DOI:10.1159/000184581

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

The psychological aspects (personal traits, way of relating to the surrounding environment, perception of body image, degree of self-esteem) of eight adults with childhood onset growth hormone (GH) deficiency (GHD) were studied before and after 6 months of recombinant GH therapy. Each subject was evaluated using the following tests: the Bern Sex Role test, the non-verbal scales of the WAIS test for adults, the State-Trait Anxiety Inventory, the Experiential-World Inventory, the Image-Marking Method and the Draw-a-Person test; a psychoneurophysiological profile was also evaluated in order to monitor, by means of four neurophysiological variables (muscular tension, galvanic resistance, skin temperature and heart rate), the reactions to specific and aspecific stress. Before treatment, adults with GHD tended to underestimate their body size by an average of 30%, with peaks of 47% for the head area; furthermore, they showed a low level of self-esteem, a closed attitude towards social relationships, a pessimistic attitude with a tendency towards depression and a strong sense of detachment from the outside world. After 6 months of GH treatment, patients presented an overall improvement in relation to intellectual tasks, accompanied by a lower level of stress during their performance. A clear improvement was also observed in terms of emotional control during specific and aspecific stress, which might contribute a positive effect on their interrelationships. As expected, the treatment was not able to reduce the subjects’ highly distorted perception of body image, due to the fact that GH treatment, despite a clear amelioration of lean/fat body mass ratio, did not change their body proportions. The finding that 6 months after stopping GH therapy, the psychological characteristics of patients reverted to those recorded before treatment supports the GH dependence of the effects observed during therapy. In conclusion, our study seems to suggest that adults with GHD, despite adequate replacement therapy (but not with GH), experience psychological difficulties which seem to be positively influenced by GH therap

ISSN:1663-2818    

DOI:10.1159/000184582

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000184647

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

To determine the final height of patients with precocious pubery treated with medroxyprogesterone acetate (MPA; 150 mg every week) for a period > 1 year (mean ± SD = 3.24 ± 1.85 years), data from a group of 26 girls were analyzed. The attained final height was 155.6 ± 8.06 cm ( 1.1 SD of the normal population). In a group of 8 untreated girls with precocious puberty, adult height was 149.2 ± 5.07 (-2.16 SD, p 12 years at the end of treatment, the final height was 153.03 ± 6.28 cm. Our data demonstrate the effectiveness of MPA treatment on ultimate height. The better height observed in those patients who stopped treatment with a bone age < 12 years suggests the advantage of discontinuing therapy before reaching a more advanced degree of skeletal mat

ISSN:1663-2818    

DOI:10.1159/000184583

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

To determine the relationship between insulin resistance and weight loss in early obesity, we used the euglycemic, hyperinsulinemic clamp to study the effect of a 14-day weight reduction diet in 10 prepubertal and early pubertal obese children (age, 10.1 ± 1.6 years) on insulin sensitivity. Body weight decreased from 73.7 ± 6.0 kg to 69.1 ± 5.8 kg (p < 0.01). Insulin sensitivity before weight reduction negatively correlated with the amount of weight loss during diet (r = -0.8, p < 0.005). Weight loss also positively correlated with height standard deviation score (r = 0.9, p < 0.005). Mean insulin sensitivity increased from 0.068 ± 0.01 (nmol kg-1 min-1 H) (pmol 1-1) to 0.096 ± 0.030 (nmol kg-1 min-1)/(pmol 1-1) (p < 0.05, one-tailed test). These results indicate that weight reduction decreases insulin resistance in childhood obesity. The inverse relationship between insulin sensitivity and weight loss during calorie restriction in these subjects suggests that insulin resistance may enhance weight loss during calorie restric

ISSN:1663-2818    

DOI:10.1159/000184584

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000317358

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We have previously reported on high thyroid-stimulating hormone (TSH) concentrations in clinically euthyroid children with congenital (CH) undergoing appropriate treatment. Whether this TSH is biologically active or not is still unclear. It has been shown that ectopic thyroid tissue does not involute during thyroxine (T4 2 pmol/l) several years after the T4 treatment had been started. In 8 of the children, Tg was measured as early as the time of diagnosis and followed up for at least 3 years. The Tg levels decreased much more slowly than the TSH levels did, and secondary Tg rises were observed. By 5 months of age, all children had Tg levels less than 25 pmol/l. Although in some infants the Tg levels paralleled TSH behavior, in others the TSH-Tg correlation was not so obvious. In another group of 8 children who had high TSH values despite normal T4, the LT4 replacement dosage was increased by 60% for 1 week (from 3.5 ± 0.2 to 5.5 ± 0.5 μg/kg/day) in order to examine the TSH-Tg dependence. As a result, the serum levels of T4 increased from 143 ± 10 to 176 ± 12 nmol/l, while the levels of TSH and Tg decreased from 8.1 ± 2.1 mU/l and 4.5 ± 0.5 ρmol/l to 1.7 ± 0.5 mU/l and 2.9 ± 0.6 pmol/l, respectively (p < 0.05). The data suggest that in primary CH children with ectopic thyroid tissue the residual gland is active and secretes Tg in response to endogenous TSH, years after the T4 replacement treatment has been started. Therefore the high TSH found in some CH children despite adequate LT4 replacement treatment is biologically active and easily suppressible with the increase in LT4 dosage. Since Tg is TSH dependent and since Tg clearance is much slower compared to TSH clearance, Tg might be useful in monitoring more accurately the long-term compliance to the therapeutic protocol. Tg monitoring is especially valuable in those infants with fluctuating high TSH levels despite normal T4

ISSN:1663-2818    

DOI:10.1159/000184585

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We investigated, in 20 patients with Graves’ disease and presenting with both a surgically induced hypothyroid state and increased serum antibodies (Ab) to the TSH receptor (R) levels, the relationships between thyroid status and the serum TSH-R or peroxidase (TPO) Ab levels under L-T4 treatment and after L-T4 cessation. The prevalence of positive TSH-R Ab (100%) and the log mean TSH-R Ab level (1.41 ± 0.04%) observed during the surgically induced hypothyroid state decreased (p < 0.001, p < 0.01, respectively) under L-T4 therapy (prevalence of positive TSH-R Ab = 50%, log mean TSH-R Ab level =1.21 ± 0.05%) and increased again (p < 0.001) after L-T4 cessation (prevalence of positive TSH-R Ab = 85%, log mean TSH-R Ab level = 1.45 ± 0.06%) to reach levels lower ( < 0.01) than that observed during the hypothyroid state for prevalence of positive TSH-R Ab but similar to that obtained during such a state for log mean TSH-R Ab value. The log mean TPO Ab level obtained during the surgically induced hypothyroid state (3.2 ± 0.5 titer) decreased (p < 0.02) under L-T4 therapy (1.8 ± 0.2 titer) and increased again (p < 0.02) after L-T4 cessation (3.0 ± 0.5 titer) to reach a similar level to that obtained during the surgically induced hypothyroid state. There were positive correlations between log TSH levels and log TSH-R Ab values (r = 0.40, p < 0.001) or log TPO Ab levels (r = 0.33, p < 0.01). Likewise, negative correlations (p < 0.01) were found between FT4 values and log TSH-R Ab levels (r = -0.34) or log TPO Ab values (r = -0.31). In conclusion, our results suggest that thyroid hormonal status can modulate thyroid autoimmunity expression, such as serum TSH-R and TPO Ab levels in hypothyroid patients with Graves

ISSN:1663-2818    

DOI:10.1159/000184586

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000317359

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Using gas chromatography and mass spectrometry we have studied the ratios of steroid metabolites and 24-hour urinary steroid excretion rates in 37 men of whom 14 where positive for the human immunodeficiency virus (HIV; group A), while 9 had acquired immunodeficiency syndrome (AIDS; group B). Controls were sick non-AIDS patients admitted to an intensive care unit (ICU) and healthy volunteers. In groups A and B and the ICU controls, there was a reduction in the excretion of adrenal androgen metabolites and a reduced ratio of 5α to 5β androgen metabolites. These data suggest that adrenal androgens are removed in HIV and AIDS in a similar manner to other systemic illnesses. In group B patients and the sick controls, the ratios of cortisol to cortisone metabolites were raised compared with controls. Daily, total cortisol metabolite excretion rates in AIDS were similar to those in patients in the ICU. The selective loss of adrenal androgens may be mediated by cytokines and influence components of the immune system. The progression of HIV to AIDS may be due in part to an imbalance between androgens and glucocorticoid

ISSN:1663-2818    

DOI:10.1159/000184587

出版商:S. Karger AG    

年代:1995

数据来源: Karger