ORIGINAL PAPER
Angle of trunk rotation in children suffering from growth hormone deficiency
1
Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
2
Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2022-08-23
Final revision date: 2022-11-05
Acceptance date: 2022-11-06
Publication date: 2023-03-31
Corresponding author
Magdalena Kobylińska
Dr. Magdalena Kobylińska, Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572, Poznan, Poland
Dr. Magdalena Kobylińska, Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572, Poznan, Poland
Pediatr Pol 2023;98(1):30-35
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Growth hormone deficiency (GHD) can lead to musculoskeletal system defects. Treatment with recombinant human growth hormone (rhGH) in children suffering from GHD increases muscle mass and improves bone structure. The purpose of this study was to evaluate the angle of trunk rotation (ATR) in patients diagnosed with GHD treated with rhGH and to observe the incidence of scoliosis.
Material and methods:
The study was conducted among 50 children diagnosed with GHD. The group consisted of 11 girls and 39 boys, aged 6–16 years. The study group included 10 children who had recently qualified for the rhGH treatment and 40 patients undergoing this treatment, with different therapy durations. The angle of trunk rotation was measured using a Bunnell scoliometer. For the purposes of the study, each patient was measured at 5 levels: C7/Th1, Th6, Th12/L1, L3, and L5/S1.
Results:
It was noted that in 10% of patients the ATR at the Th6 level was in the range 4-6°, at the Th12/L1 level 10% of children presented abnormalities in the range of 4-6° and at the L3 level 8% of patients, while at the L5/S1 level it was 5% of respondents. One person in the analyzed group (2%) presented ATR above 7° at the Th12/L1 level. Other levels tested in the research group remained within normal range. Girls had greater asymmetries compared to boys. There were no statistically significant differences in ATR comparing patients before hormonal treatment and patients undergoing rhGH treatment. The age of the beginning of the therapy, the duration of rhGH therapy, and body mass index (BMI) had no effect on ATR. Sport activities had a positive impact on the results obtained by scoliometer assessment.
Conclusions:
The angle of trunk rotation is higher in growth hormone-deficient females. Weight, height, BMI, the time of growth hormone therapy beginning, and the duration of this therapy do not influence ATR. The more sports activities undertaken, the lower the value of the angle of trunk rotation. Treatment with rhGH does not increase the incidence of scoliosis.
Growth hormone deficiency (GHD) can lead to musculoskeletal system defects. Treatment with recombinant human growth hormone (rhGH) in children suffering from GHD increases muscle mass and improves bone structure. The purpose of this study was to evaluate the angle of trunk rotation (ATR) in patients diagnosed with GHD treated with rhGH and to observe the incidence of scoliosis.
Material and methods:
The study was conducted among 50 children diagnosed with GHD. The group consisted of 11 girls and 39 boys, aged 6–16 years. The study group included 10 children who had recently qualified for the rhGH treatment and 40 patients undergoing this treatment, with different therapy durations. The angle of trunk rotation was measured using a Bunnell scoliometer. For the purposes of the study, each patient was measured at 5 levels: C7/Th1, Th6, Th12/L1, L3, and L5/S1.
Results:
It was noted that in 10% of patients the ATR at the Th6 level was in the range 4-6°, at the Th12/L1 level 10% of children presented abnormalities in the range of 4-6° and at the L3 level 8% of patients, while at the L5/S1 level it was 5% of respondents. One person in the analyzed group (2%) presented ATR above 7° at the Th12/L1 level. Other levels tested in the research group remained within normal range. Girls had greater asymmetries compared to boys. There were no statistically significant differences in ATR comparing patients before hormonal treatment and patients undergoing rhGH treatment. The age of the beginning of the therapy, the duration of rhGH therapy, and body mass index (BMI) had no effect on ATR. Sport activities had a positive impact on the results obtained by scoliometer assessment.
Conclusions:
The angle of trunk rotation is higher in growth hormone-deficient females. Weight, height, BMI, the time of growth hormone therapy beginning, and the duration of this therapy do not influence ATR. The more sports activities undertaken, the lower the value of the angle of trunk rotation. Treatment with rhGH does not increase the incidence of scoliosis.
REFERENCES (31)
1.
Improda N, Capalbo D, Esposito A, et al. Muscle and skeletal health in children and adolescents with GH deficiency. Best Pract Res Clin Endocrinol Metab 2016; 30: 771-783.
2.
Mo D, Blum WF, Rosilio M, et al. Ten-year change in quality of life in adults on growth hormone replacement for growth hormone deficiency: an analysis of the hypopituitary control and complications study. J Clin Endocrinol Metab 2014; 99: 4581-4588.
3.
Aryayev M, Senkivska L. Growth response, psychosocial problems, and quality of life in children with growth hormone deficiency. Pediatr Pol 2022; 97: 236-241.
4.
Giustina A, Mazziotti G, Canalis E. Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 2008; 29: 535-559.
5.
Møller N, Jørgensen JO. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev 2009; 30: 152-177.
6.
Seif AE. Pediatric leukemia predisposition syndromes: clues to understanding leukemogenesis. Cancer Genet 2011; 204: 227-44.
7.
Darendeliler F, G Karagiannis, Wilton P. Headache, idiopathic intracranial hypertension and slipped capital femoral epiphysis during growth hormone treatment: a safety KIGS update from the database. Horm Res 2007; 68: 41-47.
8.
Yun YH, Kwon SS, Koh Y, et al. Influence of growth hormone treatment on radiographic indices of the spine: propensity-matched analysis. J Orthop Surg Res 2017; 12: 130.
9.
Clayton PE, Cowell CT. Safety issues in children and adolescents during growth hormone therapy – a review. Growth Horm IGF Res 2000; 10: 306-317.
10.
Dymling JF, Willner S. Progression of a structural scoliosis during treatment with growth hormone. A case report. Acta Orthop Scand 1978; 49: 264-268.
11.
Critical evaluation of the safety of recombinant human growth hormone administration: statement from the Growth Hormone Research Society. J Clin Endocrinol Metab 2001; 86: 1868-1870.
12.
Darendeliler F. Safety of Growth Hormone Treatment. J Clin Res Ped Endo 2009; Suppl 1: 36-43.
13.
Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013; 7: 3-9.
14.
Bunnell WP. An objective criterion for scoliosis screening. J Bone Joint Surg Am 1984; 66: 1381-1387.
15.
Krawczynski A, Kotwicki T, Szuic A, et al. Clinical and radiological assessment of vertebral rotation in idiopathic scoliosis. Orthop Traumatol Rehabil 2006; 8: 602-607.
16.
Białek M, Kotwicki T, M’hango A, et al. Vale of trunk rotation angle within the primary and compensatory curves in children with idiopathic scoliosis subjected to intense, individual FITS kinesitherapy. Ann Acad Med Siles 2007; 61: 45-48.
17.
Lenke L, Edwards C, Bridwell K. The lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine. Spine 2003; 28: 199-207.
18.
Kotwicki T, Frydryk K, Lorkowska M, et al. Repeatability and consistency of measurement of trunk rotation with a Bunnell scoliometer in children with idiopathic scoliosis. Fizjoter Pol 2006; 6: 111-116.
19.
Bunnell WP. Selective screening for scoliosis. Clin Orthop Relat Res 2005; 434: 40-45.
20.
Wang ED, Drummond DS, Dormans JP, et al. Scoliosis in patients treated with growth hormone. J Pediatr Orthoped 1997; 17: 708-711.
21.
Bolar K, Hoffman AR, Maneatis T, et al. Long-term safety of recombinant human growth horm one in Turner Syndrome. J Clin Endocrinol Metab 2008; 93: 344-351.
22.
Kim JY, Rosenfeld SR, Keyak JH. Increased prevalence of scoliosis in Turner syndrome. J Pediatr Orthop 2001; 21: 765-766.
23.
Murakami N, Obata K, Abe Y, et al. Scoliosis in Prader-Willi syndrome: effect of growth hormone therapy and value of paravertebral muscle volume by CT in predicting scoliosis progression. Am J Med Genet A 2012; 158: 1628-1632.
24.
Nagai T, Obata K, Ogata T, et al. Growth hormone therapy and scoliosis in patients with Prader-Willi syndrome. Am J Med Genet A 2006; 140: 1623-1627.
25.
Kulis A, Goździalska A, Drąg J, et al. Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis. Int Orthop 2015; 39: 1227-1236.
26.
Esposito T, Uccello R, Caliendo R, et al. Estrogen receptor polymorphism, estrogen content and idiopathic scoliosis in human: a possible genetic linkage. J Steroid Biochem Mol Biol 2009; 116: 56-60.
27.
Wolfgram PM, Carrel AL, Allen DB. Long-term effects of recombinant human growth hormone therapy in children with Prader-Willi syndrome. Curr Opin Pediatr 2013; 25: 509-514.
28.
Wilczyński J. Body posture and somatic features in children aged 12–15 from the Świętokrzyskie province. Medical Studies 2011; 24: 29-33.
29.
Ratajczak J, Raducha D, Horodnicka-Józwa A, et al. Assessment pf physical fitness of 8 and 9-year-old children from Szczecin, Poland, involved in the obesity prevention program – pilot study. Pediatr Endocrinol Diabetes Metab 2018; 24: 65-71.
30.
Brzęk A, Sołtys J, Gallert-Kopyto W, et al. Body posture in children with obesity – the relationship to physical activity (PA). Pediatr Endocrinol Diabetes Metab 2016; 22: 148-155.
31.
Kobylińska M, Malak R, Majewska K, et al. Assessment of anterior- posterior spinal curvatures in children suffering from hypopituitarism. BMC Endocr Disord 2019; 19: 137.
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
