AvaliaÃÃo da deficiÃncia do HormÃnio de crescimento: influÃncia do estado nutricional

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Objective: The possibility of adequately diagnosing growth hormone (GH) deficiency in children and adolescents with excessive adiposity was the motivation for the present Masterâs dissertation, which is presented in the form of a review article and an original article, the aim of which was to evaluate the influence of overweight in responses to growth hormone stimulation tests. Methods: A review was made of laboratory methods for GH dosage, stimulation tests for GH secretion and the effects of obesity on the growth hormone. Information was collected from the last twenty years using the Medline, Lilacs, and MD Consult databases, as well as technical books and international publications. Further articles were identified from bibliographic references cited in the initial articles. An exploratory study was also performed to compare the release of GH in stimulation tests among children and adolescents with short stature and overweight, or at risk for overweight, to children and adolescent with adequate weight at the Referral Center of the Growth Hormone Program of the Pernambuco State Secretary of Health in the period from January 1994 to December 2004. Results: The review of the literature reveals considerable variability in the results of different GH assays and the lack of consensus regarding the cutoff points of normalcy in stimulation tests for children and adolescents, as well as the main theories attempting to explain the behavior of the GH / IGF-1 axis in obesity. In the exploratory study, 146 children and adolescents were analyzed. Among the 25 with a body mass index (BMI) equal to or greater than the 85th percentile, agreement in the responses to the clonidine and insulin hypoglycemia tests was 88% (22 / 25), which did not differ from the group with adequate weight (87.6%; 106 / 121). Responses to the clonidine and insulin hypoglycemia tests were similar in both groups. Conclusion: In the review article, it was observed that precise, universally valid GH measurements are highly desirable, but this goal remains out of reach for a variety of reasons. With the development of more sensitive and specific assays, a new definition is needed for the cutoff point in provocative tests, as there is no national or international consensus on the issue. There is most likely a multi-factor physiopathological mechanism responsible for GH deficiency in obesity. In the original article, the results suggest that overweight and risk of overweight has no influence in GH responses to stimulation tests. When investigating the relation between GH secretion and body composition among children and adolescents, it is important to use the most accurate, precise methods possible in the analysis of body composition

ASSUNTO(S)

obesidade â hormÃnio de crescimento obesidade â massa corpÃrea â secreÃÃo hormonal crianÃas e adolescentes â crescimento deficiente â baixa estatura â testes de secreÃÃo de gh pediatria

ACESSO AO ARTIGO

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