1 Department of Pediatric Division of Endocrinology, Hamad General Hospital, Doha, Qatar.
2 Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy.
3 MVZ Hausarzte Ruhr, 45467 Mulheim and Ruhr, NRW, Germany.
Research Article
World Journal of Advanced Research and Reviews, 2024, 22(01), 627-636
Article DOI: 10.30574/wjarr.2024.22.1.1123
Received on 02 March 2024; revised on 10 April 2024; accepted on 12 April 2024
Introduction: Growth hormone (GH) deficiency (GHD) in children and adolescents is traditionally managed with GH therapy, which, while effective for promoting growth, poses potential metabolic repercussions, particularly concerning glucose metabolism. This review delineates the complex interplay between GH therapy, insulin sensitivity, and glucose homeostasis.
Objective: To synthesize existing literature on the effects of GH therapy on glucose metabolism, insulin secretion, and insulin sensitivity in GH-deficient pediatric populations, aiming to illuminate the nuanced metabolic consequences and to optimize therapeutic outcomes.
Results: The reviewed studies illuminate a complex influence of GH therapy on metabolic parameters. While GH promotes growth and improves body composition, it may concurrently impair insulin sensitivity, elevate fasting glucose levels, and, in some cases, induce glucose intolerance. However, the dysglycemic effect during GH therapy appears to be transient and reversible on discontinuation of therapy. The counterbalancing role of insulin-like growth factor 1 (IGF-1) and its contribution to maintaining glucose homeostasis is also highlighted, illustrating a complex metabolic interplay induced by GH therapy.
Discussion: The findings underscore the variability in individual metabolic responses to GH therapy. The balance between GH-induced insulin resistance and IGF-1-mediated insulin sensitivity is crucial. Monitoring and adjusting GH therapy based on glycemic response is imperative to prevent adverse metabolic outcomes.
Conclusion: GH therapy in GH-deficient children and adolescents requires careful consideration of its metabolic effects. Personalized treatment strategies and vigilant monitoring of glucose metabolism are essential to optimize therapeutic outcomes and minimize the risk of metabolic complications. Further research is warranted to establish comprehensive guidelines for managing the metabolic aspects of GH therapy in this vulnerable population.
Growth hormone deficiency; GH therapy; Insulin sensitivity; Glucose homeostasis; Metabolic monitoring; Pediatric patients.
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Ashraf Soliman, Fawzia Alyafei, Vincenzo De Sanctis, Nada Alaaraj, Noor Hamed, Shayma Ahmed and Abdelrhman Bedair. The impact of growth hormone (GH) therapy on glucose metabolism: A narrative review mainly focused on GH-deficient (GHD) children and adolescents. World Journal of Advanced Research and Reviews, 2024, 22(1), 627-636. Article DOI: https://doi.org/10.30574/wjarr.2024.22.1.1123