Growth hormone resistance and somatomedins in children with end-stage liver disease awaiting transplantation

Greer, R. M., Quirk, P., Cleghorn, G. J., & Shepherd, R. W. (1998) Growth hormone resistance and somatomedins in children with end-stage liver disease awaiting transplantation. Journal of Pediatric Gastroenterology and Nutrition, 27(2), pp. 148-154.

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The success of orthotopic liver transplantation as treatment for end-stage liver disease has prompted investigation of strategies to maintain or improve nutrition and growth in children awaiting transplantation, because malnutrition is an adverse prognostic factor. The purpose of this study was to evaluate the effect of recombinant human growth hormone therapy on body composition and indices of liver function in patients awaiting transplant.


The study was designed as a placebo- controlled, double-blind, crossover trial. Patients received 0.2 U/kg growth hormone, subcutaneously, or placebo daily for 28 days during two treatment periods, separated by a 2-week washout period. Ten patients (mean age, 3.06 ± 1.15 years; range, 0.51-11.65 years, five men), with extrahepatic biliary atresia (n = 8) or two with Alagille's syndrome (n = 2), with end-stage liver disease, completed the trial while awaiting orthotopic liver transplantation. Height, weight, total body potassium, total body fat, resting energy expenditure, respiratory quotient, hematologic and multiple biochemical profile, number of albumin infusions, insulin-like growth factor-1 and 1, growth hormone binding protein (GHBP), and insulin-like growth factor binding protein-1 (IGFBP-1) and insulin-like growth factor binding protein (IGFBP-3) were measured at the beginning and end of each treatment period. Results: Growth hormone treatment was associated with a significant decline in serum bilirubin (-34.6 ± 16.5 μmol/l vs. 18.2 ± 11.59 μmol/l; p < 0.02) but there was no significant effect on any anthropometric or body composition measurements, or on any biochemical or hematologic parameters.


These children with end-stage liver disease displayed growth hormone resistance, particularly in relation to the somatomedin axis. Exogenous growth hormone administration may be of limited value in these patients

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9 citations in Web of Science®
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ID Code: 89611
Item Type: Journal Article
Refereed: Yes
Additional Information: Cited By :10
Export Date: 1 September 2015
Correspondence Address: Greer, R.M.; Children's Nutrition Research Centre, Royal Children's Hospital, Brampston Terrace, Herston, QLD 4029, Australia
Keywords: Growth hormone, Liver disease, Somatomedins, bilirubin, growth hormone binding protein, human growth hormone, potassium ion, somatomedin binding protein 1, somatomedin binding protein 3, somatomedin c, alagille syndrome, article, bile duct atresia, bilirubin blood level, body fat, child, child nutrition, clinical article, clinical trial, controlled study, crossover procedure, double blind procedure, drug effect, energy expenditure, female, growth hormone release, hormone resistance, human, liver failure, liver function, liver transplantation, male, priority journal, protein blood level, respiratory quotient, subcutaneous drug administration, total body potassium, Body Composition, Child, Preschool, Cross-Over Studies, Double-Blind Method, Drug Resistance, Humans, Infant, Liver, Liver Diseases, Nutritional Status, Placebos, Potassium
DOI: 10.1097/00005176-199808000-00004
ISSN: 0277-2116
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: © Lippincott-Raven Publishers
Deposited On: 28 Oct 2015 00:58
Last Modified: 28 Oct 2015 00:58

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