MONOCENTRIC STUDY OF 112 CONSECUTIVE PATIENTS WITH CHILDHOOD ONSET GROWTH HORMONE DEFICIENCY DURING TRANSITION

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 109-133-GHRH, GH & IGF Biology & Signaling
Bench to Bedside
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-119
Carine Courtillot1, Roselyne Baudoin1, Tatiana Du Souich2, Lucile Saatdjian1, Isabelle Tejedor1, Michel Polak3, Juliane Leger4, Graziella Pinto5, Jean-Louis Golmard1 and Philippe A Touraine*6
1GH Pitié-Salpêtrière, AP-HP, Paris, France, 2GH Pitié-Salpêtrière, AP-HP, 75013, France, 3Hopital Necker Enfants Malades, Paris Cedex 15, France, 4Hosp Robert Debre, Paris, France, 5Hopital Necker Enfants Malades, Paris, France, 6GH Pitie Salpetriere, Paris Cedex 13, France
Context: Childhood onset growth hormone deficit (CO-GHD) has consequences in adulthood, even if it has been adequately treated. Transition is a key period for GH action. Its organization is mandatory to further optimal follow-up.

Objectives: The aim was to study medical management and its impact, in CO-GHD patients, during the transition period and further adult follow-up.

Patients and methods: It is an observational retrospective cohort study on consecutive CO-GHD patients transferred in our adult endocrinological department, from a pediatric endocrinological department, over the past 2 decades. Data recorded from pediatric and adult charts were: GH treatment, pituitary function; metabolic, bone and cardiovascular parameters.

Results: We present a cohort of 112 patients, mostly with severe GHD (64%), associated to other pituitary deficits (66%) and due to acquired (56%) or congenital (33%) causes. Most patients (90%) stopped GH before transfer, at a median age of 16.3 years. Median age at transfer was 19.4 years. Somatotropic axis was re-evaluated in 80% patients: 71 had severe persistent GHD, 11 displayed a resolutive GHD (including 4 non-idiopathic GHD). IGF1 remained low in 1/3 of treated adults. Follow-up was mostly regular, and showed improvement in lipid profile and bone mineral density in patients under GH. In multivariate analysis, associated pituitary deficits seemed to be stronger determinant factors than GHD.

Conclusions: This is the largest monocentric study on medical management of CO-GHD patients around the transition period. It allows us to evaluate our practices and their evolution on a 20 years period. Our study confirms that CO-GHD can display resolution, even in non idiopathic cases. It raises concern about the frequent discontinuation of GH before transfer in the adult department, in GHD persistent-patients. Actual recommended doses of GH might be insufficient, since a third of patients maintain a low level of IGF1 under treatment, but there are also observance issues. We observed that GHD and GH treatment have consequences on bone and metabolism similar to those previously described, but we found that other pituitary deficits seem more influent on those parameters than GHD.

Nothing to Disclose: CC, RB, TD, LS, IT, MP, JL, GP, JLG, PAT

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm