, Volume 59, Issue 3, pp 643–650 | Cite as

Glucose homeostasis in GHD children during long-term replacement therapy: a case−control study

  • Donatella Capalbo
  • Andrea Esposito
  • Nicola Improda
  • Malgorzata Gabriela Wasniewska
  • Raffaella Di Mase
  • Filippo De Luca
  • Dario Bruzzese
  • Mariacarolina SalernoEmail author
Original Article



To evaluate glucose homeostasis in children with growth hormone (GH) deficiency (GHD) receiving long-term replacement therapy.


We evaluated glucose, insulin, HOmeostasis Model Assessment (HOMA-IR), and HbA1c in 100 GHD children at diagnosis and during 5 years of therapy. One hundred healthy children comparable to patients were evaluated at baseline and after 1 and 5 years.


No difference was detected at baseline between GHD patients and controls in glucose (79.58 ± 9.96 vs. 77.18 ± 8.20 mg/dl), insulin (4.50 ± 3.24 vs. 4.30 ± 2.60 µU/ml), HbA1c (5.20 ± 0.31 vs. 5.25 ± 0.33%) levels, and HOMA-IR (0.93 ± 0.72 vs. 0.86 ± 0.61). One year of GH was associated with a significant increase in insulin (7.21 ± 4.84, p < 0.001) and HOMA-IR (1.32 ± 0.98, p < 0.001) in GHD children, which became different from controls (p < 0.001 and p = 0.004). These parameters did not change further during the following years of treatment in GHD subjects. In contrast, controls did not show significant changes in insulin (4.40 ± 2.60) and HOMA-IR (0.82 ± 0.60) during the first year; however, at the fifth year of the study a significant increase in insulin (6.50 ± 3.50, p = 0.004) and HOMA-IR (1.29 ± 0.54, p < 0.001) was documented, making these parameters comparable between patients and controls.


Our results suggest that growth hormone (GH) treatment is not associated with significant impairment of insulin sensitivity in GHD children. The slight impairment observed in GHD adolescents after long-term GH is comparable to that physiologically occurring in healthy pubertal subjects.


Growth hormone deficiency GH replacement therapy Glucose homeostasis Insulin sensitivity 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration.

Informed consent

Informed parental consent for participation in the study was obtained for patients and controls and the study was authorized by the Hospital Ethical Research Committee.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Donatella Capalbo
    • 1
  • Andrea Esposito
    • 2
  • Nicola Improda
    • 1
  • Malgorzata Gabriela Wasniewska
    • 3
  • Raffaella Di Mase
    • 1
  • Filippo De Luca
    • 3
  • Dario Bruzzese
    • 4
  • Mariacarolina Salerno
    • 2
    Email author
  1. 1.Department of PediatricsUniversity “Federico II” of NaplesNaplesItaly
  2. 2.Department of Translational Medical Sciences Pediatric Endocrinology SectionUniversity “Federico II” of NaplesNaplesItaly
  3. 3.Department of Pediatric Gynecological, Microbiological and Biomedical SciencesUniversity of MessinaMessinaItaly
  4. 4.Department of Public HealthUniversity “Federico II” of NaplesNaplesItaly

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