The effects of growth hormone (GH) deficiency and GH replacement therapy on health-related physical fitness in children.

Abstract

The effects of growth hormone deficiency (GHD) and GH replacement therapy (GHRT) on health-related physical fitness are still unclear. To characterize the effects of GHD and GHRT on health-related physical fitness in children. We enrolled 49 GHD children (10.7±1.9 years) and 46 controls (11.8±2.3 years). Both groups underwent baseline assessment of body composition, muscle strength, flexibility, cardiorespiratory fitness, IGF-1, metabolic equivalents (METs-min/week), sitting time, health-related quality of life (HRQoL). These parameters were re-evaluated in GHD patients after one-year GHRT. Compared to controls, GHD patients exhibited higher sitting time (3603.5±1334.8 min/week vs 3011.6±1215.3 min/week, p=0.03), and waist-to-height ratio (WtHR) (0.50±0.07 vs 0.45±0.06, p=0.001), reduced muscle strength (squat jump 13.88±4.0 vs 15.7±4.2 cm, p=0.04; long jump 114.6±25.8 vs 126.2±29.6 cm, p=0.04, counter-movement jump 13.7±3.9 vs 16.4±4.7 cm, p=0.002), six-minute walking distance (6MWD) (501.1±69.3 vs 535.3±65.6 m, p=0.03), and maximal oxygen uptake (VO2max) (29.7±4.7 vs 31.9±4.6 ml/kg/min, p=0.02).One-year GHRT led to reduced sitting time (3107.5±1370.9 min/week, p=0.03), WtHR (0.45± 0.06, p=0.02) and fat mass % (27.4±5.4 vs 23.7±5.8, p<0.0001), increased METs-min/week (2174.5±1737.9 vs 2788.1±2395.0, p=0.05), fat-free mass (22.1±7.6 vs 27.9±9.4 kg, p<0.0001), handgrip strength (11.1±3.6 vs 15.4±4.9 kg, p=0.0001) squat jump (16.6±4.7 cm, p=0.01), long jump (129.6±25.2 cm, p<0.0001), counter-movement jump (16.0±4.3 cm, p=0.003), 6MWD (540.5±88.5 m, p=0.01), VO2max (31.8±5.1 ml/kg/min, p=0.02), and physical (76.76±16.42 vs 84.61±11.63, p<0.007) and psychosocial HRQoL scores (75.61±15.12 vs 80.91±11.12, p<0.05). GHRT exerts broad beneficial effects on health-related physical fitness and HRQoL in children with GHD.