The physical development in adolescence normally starts between thirteen (13) up to nineteen (19) years of age. During puberty, which is the onset of adolescence, the reproductive system matures because of neuroendocrine changes. The transition stage from childhood to adulthood known as adolescence is fraught with physical, emotional and social changes evident for both girls and boys. The focus of this paper, in particular, is on the correspondence between physical development of adolescents and use of growth hormones for those who have or who does not have growth hormone deficiencies (GHD).
Root, Dana, & Lippe studied the effect of recombinant human growth hormone (rhGH) among 47 infants with growth hormone (GH) deficiency until such time that they reach near-adult heights (NAH), that is, 18 years for females and 20 years for males. The research aimed to establish linear growth pattern prior to reaching near-adult stature. Nearly half (23) of the research participants later on manifested a comparable height with their parents. However, subjects with associated illnesses, sexual precocity, and severe pre-/peri-natal brain injury attained less optimal NAH. On the contrary, pubertal subjects with normal to tall statures have the tallest NAH. The researchers inferred that the introduction of rhGH during the infancy years of the research participants counteracted their GHD. Thus, the researchers recommended the use of rhGH and close monitoring for children’s linear growth pattern until such time that they attain NAH.
In another study about physical development and GH, Geffner suggested that all adolescents who were previously diagnosed with isolated growth hormone (IGH) should undergo re-testing at the start of their puberty stage. For Geffner, persistent severe GHD caused by the presence of organic diseases and/or multiple hormonal deficiencies could be confirmed by low serum insulin-like growth factor one (IGF-1) concentration. The research participants were given low dosage with upward adjustment of GH based on their age- and gender-adjusted serum IGF-1. With GH treatment, beneficial effects were noted in the prevention of GHD syndrome in their adulthood. Geffner recommended careful planning during the transition period (that is, during adolescence) and in their transfer of care to healthcare experts.
Koteva & Kamboj claimed that children with severe GHD undergo critical transition as adolescent. Some of the GH stimulation tests to confirm the presence of GHD include the GH –releasing hormones (with arginine) and insulin induced hypoglycemia. Patients were given continuous GH treatment or dose of rhGH. Then, there was a volumetric analysis (titration) and monitoring of appropriate adjustments between each participant’s IGF-1 and rhGH dosage. Koteva and Kamboj concluded that GH treatment provides numerous advantages (e.g., quality of life, lipid profile, body composition, etc.) for patients experiencing severe GHD.
Brown & McVeigh, 2009) found out that because of adolescents’ eagerness to have increased heights, they use injectable human growth hormone (IHGH). In the United Kingdom, for instance, there are many adolescents who use GHs as performance-enhancing drugs. However, because of these GHs’ limited supply and prohibitive cost, they were initially unavailable to a large number of individuals. Recent studies, however, revealed the increasing number of IHGH use. The hormone, which is usually a part of a poly-drug regimen, is being used to enhance bodily aesthetics. Despite of that fact, there are no systematic and detailed research findings regarding the use of IHGH in different cultures, supply network, motivation for use, prevalence of use, patterns of use, and related variables. As such, there are issues surrounding IHGH’s safety, effectiveness, efficacy, not to mention risks in the incidental use of adulterated products and syringe.
Lastly, there had also been an investigation in the use of four GH stimulation tests in the diagnosis of GHD among adolescents with severe short stature (SSS) . The tests (that is, glucagon, clonidine, L-dopa, and insulin tolerance tests) were administered to 11 female and 32 male participants. There were a number of tests applied to the research subjects such as glucagon to 12 participants, clonidine to 21 participants, L-dopa to 32 participants, and insulin to all the research subjects. Then, there was also inter-comparison that was performed (e.g., insulin tests in comparison to responses for L-dopa. Moreover, specificity, sensitivity, and predictive values of the four tests were also computed. Subjects without any response to the two tests were categorized as having GHD. The study showed that there were no significant differences in the three (3) tests compared to ITT. Glucagon test registered a 100% sensitivity, predictive values, and specificity. The remaining three (3) tests (i.e., clonidine, L-dopa, and insulin tolerance tests) had 90% specificity whereas clonidine tests had the highest positive predictive value (PPV). Moreover, ITT test had 86% and 91% negative PV and sensitivities, respectively. L-dopa test had 90% and 94% negative PV and sensitivities, respectively. In conclusion, since the negative PV of ITT, glucagon, and L-dopa were high, the researchers suggested that they should be used first as tests in the diagnosis of SSS.
Growth hormones (GH) were proven inconclusively to offer many beneficial effects in the physical development (specifically, height) in adolescence. There were studies concerned with the early detection, testing/diagnosis and treatment of abnormalities in the physical growth of adolescents. Recombinant human growth hormone (rhGH) for children to injectable human growth hormone (ihGH) for late adolescents prove to have beneficial effects. However, much needs to be done in order to come up with more compelling and conclusive research results. Hence, the various advantages of GH seem to be more promising for individuals who have severe short stature (SSS). Since these SSS adolescents suffer the most psychosomatic, physiological, and social problems, researchers should focus more on them.
References
Brown, M., & McVeigh, J. (2009). Injecting human growth hormone as a performance-enhancing drug -- perspectives from the United Kingdom. Journal Of Substance Use, 14(5), 267-288. doi:http://dx.doi.org/10.3109/14659890903224383
Eren, M., Tabur, S., Turan, M., Sarıfakioğulları, S., & Sabuncu, T. (2010). Comparison of Diagnostic Values of Growth Hormone Stimulation Tests in Adolescents. Turkish Journal Of Endocrinology & Metabolism, 14(1), 6-9.
Geffner, M. (2009). Growth Hormone Replacement Therapy: Transition from Adolescence to Adulthood. Journal Of Clinical Research In Pediatric Endocrinology, 1(5), 205-208. doi:10.4274/jcrpe.v1i5.205
Koteva, K., & Kamboj, M. (2009). Transition of growth hormone treatment: adolescence to adulthood. Current Pediatric Reviews, 5(3), 176-179.
Root, A., Dana, K., & Lippe, B. (2011). Treatment of Growth Hormone-Deficient Infants with Recombinant Human Growth Hormone to Near-Adult Height: Patterns of Growth. Hormone Research In Paediatrics, 75(4), 276-283. doi:10.1159/000322881
