Hormone Research in Paediatrics
Original Paper
Acute Effects of Blood Transfusion on Growth Hormone and Insulin-Like Growth Factor-1 Levels in Children with ThalassemiaMahachoklertwattana P. · Yimsumruay T. · Poomthavorn P. · Chuansumrit A. · Khlairit P.Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: April 28, 2010
Accepted: September 08, 2010
Published online: November 04, 2010
Issue release date: March 2011
Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2
ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)
For additional information: https://www.karger.com/HRP
Abstract
Background/Aim: Children with β-thalassemia have chronic anemia and growth retardation. Impaired growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis function has been demonstrated. Growth improvement has been demonstrated following optimal blood transfusion. Whether correction of anemia by blood transfusion augments GH-IGF-1 axis function has not been established. Methods: Twenty children with thalassemia aged 11.7 years (5.3–16.3 years) were recruited. GH provocative tests were performed twice, before and 1 week after blood transfusion. IGF-1, IGF-binding protein-3 (IGFBP-3) and hematocrit were measured. Results: Median IGF-1 and IGFBP-3 concentrations were significantly increased at 1 week following transfusion: pre- versus posttransfused concentrations: 86.4 versus 143.5 ng/ml (p < 0.001) and 2.95 versus 3.75 mg/l (p < 0.001), respectively. However, median peak GH levels and areas under the curve of GH during GH testing between pre- and posttransfusion periods were not different. The pretransfused hematocrit level was correlated with pretransfused IGF-1 (r = 0.662, p < 0.001) and IGFBP-3 (r = 0.691, p < 0.001) levels. Conclusions: In thalassemics, correction of anemia by blood transfusion rapidly enhanced GH-mediated IGF-1 and IGFBP-3 secretion. This suggests thatanemia may be one of the factors causing partial GH insensitivity.
© 2010 S. Karger AG, Basel
Related Articles:
References
- Low LC: Growth of children with beta-thalassemia major. Indian J Pediatr 2005;72:159–164.
- Rund D, Rachmilewitz E: β-Thalassemia. N Engl J Med 2005;353:1135–1146.
- Theodoridis C, Ladis V, Papatheodorou A: Growth and management of short stature in thalassemia major. J Pediatr Endocrinol Metab 1998;11(suppl 3):835–844.
-
Grundy RG, Wood KA, Savage MO, Evan JPM: Relationship of endocrinopathy to iron chelation status in young patients with thalassemia major. Arch Dis Child 1994;74:128–132.
External Resources
-
De Sanctis V: Growth and puberty and its management in thalassemia. Horm Res 1992;58(suppl 1):72–79.
- De Sanctis V, Eleftheriou A, Malaventura C: Prevalence of endocrine complications and short stature in patients with thalassemia major: a multicenter study by Thalassemia International Federation. Pediatr Endocrinol Rev 2004;2(suppl 2):249–255.
- Karamifar H, Karimi M, Amirhakimi G, Shabatialaei M, De Sanctis V: Reduced insulin-like growth factor I concentrations in iron-overloaded beta thalassaemic patients with normal growth hormone secretion and liver function. Pediatr Endocrinol Rev 2004;2(suppl 2):256–258.
- Moayeri H, Oloomi Z: Prevalence of growth and pubertal failure with respect to growth hormone and gonadotropins secretion in β-thalassemia major. Arch Iran Med 2006;9:329–334.
- Chrysis DC, Alexandrides TK, Koromantzou E, Georgopoulos N, Vassilakos P, Kiess W, Kratsch J, Beratis NG, Spiliotis BE: Novel application of IGF-1 and IGFBP-3 generation tests in the diagnosis of growth hormone axis disturbances in children with β-thalassemia. Clin Endocrinol 2001;54:253–259.
- Scacchi M, Danesi L, Cattaneo A, Valassi E, Giraldi FP, Argento C, D’Angelo E, Mirra N, Carnelli V, Zanaboni L, Tampieri B, Cappellini MD, Cavagnini F: Bone demineralization in adult thalassemic patients: contribution of GH and IGF-1 at different skeletal sites. Clin Endocrinol 2008;69:202–207.
- Low LCK, Postel-Vinay MC, Kwan EYW, Cheung PT: Serum growth hormone (GH) binding protein, IGF-1 and IGFBP-3 in patients with β-thalassemia major and the effect of GH treatment. Clin Endocrinol 1998;48:641–646.
- Katzos G, Papakostantinou-Anthanasiadou E, Athanasiou-Metaxa M, Harsoulis F: Growth hormone treatment in short children with beta-thalassemia major. J Pediatr Endocrinol Metab 2000;13:163–170.
- Wu KH, Tsai FJ, Peng CT: Growth hormone (GH) deficiency in patients with β-thalassemia major and the efficacy of recombinant GH treatment. Ann Hematol 2003;82:637–640.
- Geffner ME, Karlsson H: Use of recombinant human growth hormone in children with thalassemia. Horm Res 2009;71(suppl 1):46–50.
- Isguven P, Arslanoglu I, Erol M, Yildiz M, Adal E, Erguven M: Serum levels of ghrelin, leptin, IGF-I, IGFBP-3, insulin, thyroid hormones and cortisol in prepubertal children with iron deficiency. Endocr J 2007;54:985–990.
- Sheashaa HA, Khilil A, Aarman MM, El-Shahat HE, Selim A, El-Gawad SS: Correction of hemodialysis anemia is associated with significant increase in serum concentration of IGF-I in patients treated with erythropoietin: a randomized controlled study. Int Urol Nephrol 2005;37:153–158.
- Ceppi A, Mullis PE, Eggenberger E, Blum JW: Growth hormone concentration and disappearance rate, insulin-like growth factors I and II and insulin levels in iron-deficient veal calves. Ann Nutr Metab 1994;38:281–286.
- Luporini SM, Bendit I, Manhani R, Bracco OL, Manzella L, Giannella-Neto D: Growth hormone and insulin-like growth factor-1 axis and growth of children with different sickle cell anemia haplotypes. J Pediatr Hematol Oncol 2001;23:357–363.
- Mahachoklertwattana P, Chuansumrit A, Sirisriro R, Choubtum L, Sriphrapradang A, Rajatanavin R: Bone mineral density, biochemical and hormonal profiles in suboptimally treated children and adolescents with β-thalassemia disease. Clin Endocrinol 2003;58:273–279.
- La Rosa C, De Sanctist V, Mangiagli A, Mancuso M, Guardabasso V, Galati MC, Caruso-Nicoletti M: Growth hormone secretion in adult patients with thalassemia. Clin Endocrinol 2005;62:667–671.
- Soliman A, eIZalabany M, Amer M, Ansari BM: Growth and puberty development in transfusion-dependent children and adolescents with thalassemia major and sickle cell disease. J Trop Pediatr 1999;45:23–30.
-
Soliman A, Banna N, Ansari BM: GH response to provocation and circulating IGF-1 and IGF-binding protein-3 concentrations, the IGF-1 generation test and clinical response to GH therapy in children with β-thalassemia. Eur J Pediatr 1998;138:394–400.
External Resources
-
Department of Health, Ministry of Public Health, Thailand: Reference for weight, height and nutritional indices in Thais aged 1 day to 19 years. Bangkok, Department of Health, Ministry of Public Health, Thailand, 2000.
- Winichagoon P, Fucharoen S, Chen P, Wasi P: Genetic factors affecting clinical severity in β-thalassemia syndromes. J Pediatr Hematol Oncol 2000;22:573–580.
- Xu S, Gu X, Pan H, Zhu H, Gong F, Li Y, Xing Y: Reference ranges for serum IGF-1 and IGFBP-3 levels in Chinese children during childhood and adolescence. Endocr J 2010;57:221–228.
- Bernstein D, Jesper JR, Rosenfeld RG, Hinz RL: Decrease serum insulin-like growth factor-1 associated with growth failure in newborn lambs with experimental cyanotic heart disease. J Clin Invest 1992;89:1128–1132.
- Dinleyici EC, Kilic Z, Buyukkaragoz B, Ucar B, Alatas O, Aydogdu SD, Dogruel N: Serum IGF-1 and IGFBP-3 and growth hormone levels in children with congenital heart diseases: relationship with nutritional status, cyanosis and left ventricular functions. Neuroendocrinol Lett 2007;28:279–283.
- Ghigo E, Bellone J, Aimaretti G, Bellone S, Loche S, Cappa M, Bartolotta E, Dammacco F, Camanni F: Reliability of provocative tests to assess growth hormone secretory status. Study in 472 normally growing children. J Clin Endocrinol Metab 1996;81:3323–3327.
Article / Publication Details
Received: April 28, 2010
Accepted: September 08, 2010
Published online: November 04, 2010
Issue release date: March 2011
Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2
ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)
For additional information: https://www.karger.com/HRP
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
