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Friday, August 15, 2014

Growth Hormone Therapy Found to be Associated with Stroke in Adulthood

by Dawn Fallik


Every year, some children who receive growth hormone treatment (GHT) do so for cosmetic reasons—they are short in a world that admires being tall. But a new study raises concerns that GHT might have dangerous consequences in the long-term, with an associated risk for stroke in adulthood.


Child with growth hormone deficiency (left) shown here with a fraternal twin sister.


 The study, published in the Aug.13 online edition of Neurology, reviewed adult morbidity data on 6,874 people collected from the French cohort of the Safety and Appropriateness of Growth hormone treatments in Europe trial, or SAGhE, a multinational prospective European study that assessed long-term mortality and morbidity in people who were treated with GH in childhood.


For the current study, the authors collected data on the children with idiopathic isolated GH deficiency or short stature who started GHT between 1985 and 1996. About 75 percent of the group had isolated GH deficiency and 13 percent had idiopathic short stature. 


An earlier analysis, published in 2012 in the Journal of Clinical Endocrinology and Metabolism, showed increased cardiac and cerebrovascular mortality among the French cohort of SAGhE.


For the Neurology paper, the research team reviewed medical records, imaging data, and questionnaires that had been sent to patients, specifically looking at cerebrovascular events that were validated by stroke neurologists. They compared the results with data on stroke incidence obtained from population-based registries in Dijon, France, and Oxford, United Kingdom. They concluded that there was a higher risk of stroke among patients treated with GH in childhood, with a standardized incidence ratio of 2.2-5.3 for all stroke subtypes, and 5.7-7.0 for hemorrhagic stroke.


    At an average follow-up of 17.4 years, there were 11 incident strokes at a mean age of 24 years—three intracerebral hemorrhages, three ischemic strokes, and five cases of subarachnoid hemorrhage (SAH); four of the patients died from SAH.


    “Patients treated with GH worldwide should be advised about this association and further studies should evaluate the potentially casual role of GH treatment in these findings,” the study authors wrote.


Look for the full discussion and experts’ commentary in the August 21 issue of Neurology Today. For more coverage of GHT, browse our archives here: