Sunao Honda

Asymptomatic isolated microhaematuria: natural history of 136 children.

In a mass screening programme, 251 children with isolated microhaematuria were detected. Of these 251 children, 115 were excluded from the study because of microhaematuria, secondary to a specific cause. The remaining 136 children were diagnosed as having asymptomatic isolated microhaematuria (ASH). Of these 136 children, 23 had evidence of urinary abnormalities in their family members. Red blood cell casts were evident in 31 children at their initial visit or during the follow-up period. Ten children had one or more episodes of macrohaematuria during the study. Renal biopsy was performed in 19 children because of indications of glomerular discase, and 13 of these 19 children had mild to moderate glomerulonephritis. None of these 136 children developed hypertension or renal impairment after a mean period of 7.4 years (range 6–13 years). Thirty-five children had normal urinary findings within 6 years of their initial visit, and 100 have had persistent microhaematuria, without proteinuria throughout the follow-up period. The other child had microhaematuria with proteinuria greater than 1 g/m2 per day at the end of the study. This study suggests that the prognosis of ASH is good and that renal biopsy is not indicated for children with ASH.

Beneficial effect of growth hormone on atherogenic risk in children with growth hormone deficiency.

We studied changes in the atherogenic index (total cholesterol divided by high-density lipoprotein cholesterol) in 12 prepubertal boys with growth hormone (GH) deficiency during 9 months of GH treatment. High-density lipoprotein cholesterol level increased until 5 months without significant changes in total cholesterol level; thus GH therapy may be beneficial in reducing the atherogenic index in boys with GH deficiency.

Body composition, atherogenic risk factors and apolipoproteins following growth hormone treatment

We studied the change in atherogenic risk factors in 27 children, 21 boys and 6 girls, 6 to 14 years of age. with growth hormone deficiency during 12 months of growth hormone replacement therapy. Changes in body composition and lipid profile during growth hormone treatment were evaluated. The atherogenic index was calculated using the equation [(total cholesterol ‐ high‐density lipoprotein cholesterol)(apolipoprotein B)] / [(apolipoprotein A1)(high‐density lipoprotein cholesterol)]. Body fat decreased (p < 0.01), associated with an increase in lean body mass (p < 0.01). Total cholesterol and high‐density lipoprotein cholesterol showed no significant changes. The atherogenic index significantly decreased from 1.44 ± 0.60 to 1.09 ± 0.52 (p < 0.01) after 12 months. Apolipoproteins Cu and Cm increased throughout the study period (p < 0.01). Lipoprotein(a) and apolipoproteins A1, B and B/A1 ratio did not change significantly. In conclusion, growth hormone treatment improved body composition and reduced atherogenic risk factors in children with growth hormone deficiency.

Lipoprotein (a) changes during growth hormone treatment

Sirs, The strong relation between lipoprotein (a) (Lp(a)) and atherosclerotic disorders is well established (Dahlen et al., 1991). Several recent reports have commented on the changes of Lp(a) levels during treatment with GH. However, controversy exists regarding such a relation. Eden et al. (1993) found an increase in Lp(a) during treatment of adult patients with GH for 6 months. This was also found by Olivecronaet al. (1993) in their 7-day study which indicated a similar increase in Lp(a). On the contrary, Russel-Jones et al. (1994) found no significant changes in Lp(a) levels during 2 months of GH treatment in GH deficient adults. To our knowledge, no previous reports about Lp(a) changes during GH treatment in children have been published. We investigated 22 male children with growth hormone deficiency (aged 614 years, height standard deviation score between -4.3 and -2) treated with recombinant GH in a dose of 0.5 IU/kg/week for 12 months to assess changes in Lp(a) during the course of treatment. Fasting blood samples were taken before the start of treatment and at 1,2,3, 5,7,9 and 12 months of therapy. Lp(a) was detected by the fully automated latex immunoassay method as it is sensitive, specific and accurate (Abe et al., 1994). Statistical analysis of the results was performed by analysis of variance (ANOVA). No significant changes in Lp(a) were shown throughout the I-year study period. We conclude that longer duration of treatment with recombinant GH has no significant effect on Lp(a) levels in children. On the other hand, we have previously documented that GH treatment reduces the atherogenic index in GH deficient children (Kohno et al., 1994). We believe that GH replacement therapy may have a beneficial effect on atherogenic risk factors in children with GH deficiency. H. M. S. Hasan*?, H. Kohno*, R. Kuromaru*t, S. Honda* and K. Uedat *Department of Endocrinology and Metabolism. Fukuoka Childrens Hospital, and f Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Unfavourable impact of growth hormone (GH) discontinuation on body composition and cholesterol profiles after the completion of height growth in GH-deficient young adults

Aim:u2003Growth hormone (GH) plays an important role in the regulation of body composition and metabolism. GH deficiency is associated with obesity and hypercholesterolemia, which respond to GH treatment. In this study we evaluated changes in body composition and cholesterol profiles after discontinuation of GH therapy to assess atherogenic risk factors in GH‐deficient patients.