The influence of pituitary volume on the growth response in growth hormone-treated children with growth hormone deficiency or idiopathic short stature
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Magnetic resonance imaging (MRI) can be used for assessing the morphology of the pituitary gland in children with short stature. The purposes of this study were: (1) to determine if pituitary volume (PV) can distinguish patients with growth hormone (GH) deficiency from those with idiopathic short stature (ISS), (2) to validate an association between PV and severity of GH deficiency, and (3) to compare PV between good and poor response groups in children with GH deficiency or ISS after 1 year of treatment.Methods: Data were collected from the medical records of 152 children with GH deficiency or ISS who underwent GH stimulation test, sella MRI, and GH treatment for at least 1 year. Estimated PVs were calculated using the formula of an ellipsoid. We compared the PVs in patients with GH deficiency with those of patients with ISS. In addition, we assessed the association between PV and severity of GH deficiency, and we assessed growth response after treatment.Results: No difference was observed in PV between patients with GH deficiency and those with ISS. The severity of the GH deficiency seemed to be associated with PV (<i>P</i>=0.082), and the height of the pituitary gland was associated with severity of GH deficiency (<i>P</i><0.005). The PV in the good response group was less than that of the poor response group in patients with GH deficiency (<i>P</i><0.005), and PV showed no association with responsiveness to GH treatment in patients with ISS (<i>P</i>=0.073).Conclusion: The measurement of PV cannot be used for differential diagnosis between GH deficiency and ISS. In patients with GH deficiency, PV tended to be smaller as the severity of GH deficiency increased, but the difference was not significant. PV may be a good response predictor for GH treatment. Further studies, including a radiomics-based approach, will be helpful in elucidating the clinical implications of pituitary morphology in patients with short stature.
Abstract
Purpose: Magnetic resonance imaging (MRI) can be used for assessing the morphology of the pituitary gland in children with short stature. The purposes of this study were: (1) to determine if pituitary volume (PV) can distinguish patients with growth hormone (GH) deficiency from those with idiopathic short stature (ISS), (2) to validate an association between PV and severity of GH deficiency, and (3) to compare PV between good and poor response groups in children with GH deficiency or ISS after 1 year of treatment.Methods: Data were collected from the medical records of 152 children with GH deficiency or ISS who underwent GH stimulation test, sella MRI, and GH treatment for at least 1 year. Estimated PVs were calculated using the formula of an ellipsoid. We compared the PVs in patients with GH deficiency with those of patients with ISS. In addition, we assessed the association between PV and severity of GH deficiency, and we assessed growth response after treatment.Results: No difference was observed in PV between patients with GH deficiency and those with ISS. The severity of the GH deficiency seemed to be associated with PV (<i>P</i>=0.082), and the height of the pituitary gland was associated with severity of GH deficiency (<i>P</i><0.005). The PV in the good response group was less than that of the poor response group in patients with GH deficiency (<i>P</i><0.005), and PV showed no association with responsiveness to GH treatment in patients with ISS (<i>P</i>=0.073).Conclusion: The measurement of PV cannot be used for differential diagnosis between GH deficiency and ISS. In patients with GH deficiency, PV tended to be smaller as the severity of GH deficiency increased, but the difference was not significant. PV may be a good response predictor for GH treatment. Further studies, including a radiomics-based approach, will be helpful in elucidating the clinical implications of pituitary morphology in patients with short stature.
참고문헌 (20)
- Naderi F, "Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions", J Pediatr Endocrinol Metab, 28, pp.117~123 (2015)
- Growth Hormone Research Society, "Consensus guidelines for the diagnosis and treatment of growth hormone(GH)deficiency in childhood and adolescence : summary statement of the GH Research Society. GH Research Society", J Clin Endocrinol Metab, 85, pp.3990~3993 (2000)
- Triulzi F, "Evidence of a congenital midline brain anomaly in pituitary dwarfs : a magnetic resonance imaging study in 101 patients", Pediatrics, 93, pp.409~416 (1994)
- Nagel BH, "Magnetic resonance images of 91 children with different causes of short stature : pituitary size reflects growth hormone secretion", Eur J Pediatr, 156, pp.758~763 (1997)
- Arends NJ, "MRI findings of the pituitary gland in short children born small for gestational age(SGA)in comparison with growth hormone-deficient(GHD)children and children with normal stature", Clin Endocrinol(Oxf), 57, pp.719~724 (2002)
- Deeb A, "Pituitary gland size is a useful marker in diagnosing isolated growth hormone deficiency in short children", J Pediatr Endocrinol Metab, 28, pp.981~984 (2015)
- Bordallo MA, "Neuroradiological investigation in patients with idiopathic growth hormone deficiency", J Pediatr(Rio J), 80, pp.223~228 (2004)
- Maghnie M, "Magnetic resonance imaging of the hypothalamus-pituitary unit in childrensuspected of hypopituitarism : who, how and when toinvestigate", J Endocrinol Invest, 27, pp.496~509 (2004)
- Kim JH, "The 2017 Korean national growth charts for children and adolescents : development, improvement, and prospects", Korean J Pediatr, 61, pp.135~149 (2018)
- Hyun SE, "Reference values for serum levels of insulin-like growth factor-I and insulin-like growth factor binding protein-3in Korean children and adolescents", Clin Biochem, 45, pp.16~21 (2012)
- Greulich WW, "Radiographic atlas of skeletal development of the hand and wrist" (1959), Stanford University Press
- Sari S, "Measures of pituitary gland and stalk : from neonate to adolescence", J Pediatr Endocrinol Metab, 27, pp.1071~1076 (2014)
- Grimberg A, "Guidelines for growth hormone and insulin-like growth factor-I treatment in children and adolescents : growth hormone deficiency, idiopathic short stature, and primary insulin-like growth factor-I deficiency", Horm Res Paediatr, 86, pp.361~397 (2016)
- Bang P, "A comparison of different definitions of growth response in short prepubertal children treated with growth hormone", Horm Res Paediatr, 75, pp.335~345 (2011)
- Aimaretti G, "Reduction of the pituitary GH releasable pool in short children with GH neurosecretory dysfunction", Clin Endocrinol(Oxf), 52, pp.287~293 (2000)
- Kara Ö, "Relevance of Pituitary gland magnetic resonance imaging results with clinical and laboratory findings in growth hormone deficiency", Med Sci Monit, 24, pp.9473~9478 (2018)
- Kessler M, "Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls", J Pediatr Endocrinol Metab, 29, pp.1195~1200 (2016)
- Lee T, "A radiomics-based model with the potential to differentiate growth hormone deficiency and idiopathic short stature on sella MRI", Yonsei Med J, 63, pp.856~863 (2022)
- Ariza Jiménez AB, "Differences between patients with isolated GH deficiency based on findings in brain magnetic resonance imaging", Endocrinol Diabetes Nutr(Engl Ed), 67, pp.78~88 (2020)
- Khadilkar VV, "Response of indian growth hormone deficient children to growth hormone therapy : association with pituitary size", Indian J Pediatr, 82, pp.404~409 (2015)