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Dynamic response of C‐type natriuretic peptide and its aminoterminal propeptide ( NT pro CNP ) to growth hormone treatment in children with short stature
Author(s) -
Olney Robert C.,
Salehi Parisa,
Prickett Timothy C.R.,
Lima John J.,
Espiner Eric A.,
Sikes Kaitlin M.,
Geffner Mitchell E.
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13103
Subject(s) - medicine , endocrinology , natriuretic peptide , idiopathic short stature , short stature , leptin , alkaline phosphatase , blood sampling , biomarker , bone age , hormone , growth hormone , biology , obesity , heart failure , biochemistry , enzyme
Summary Objective C‐type natriuretic peptide ( CNP ) and its aminoterminal propeptide ( NT pro CNP ) are potential biomarkers of recombinant human growth hormone (rh GH ) efficacy. The objective of this study was to describe the pharmacodynamics of plasma CNP and NT pro CNP levels in response to rh GH treatment and to identify the optimal time of sampling after starting rh GH . Design This was a prospective, observational study. Subjects were treated with rh GH for 1 year, with blood sampled at regular intervals. Patients Eighteen prepubertal children, eight with low levels of GH on biochemical testing and ten with idiopathic short stature, completed the study. Measurements Blood levels of CNP , NT pro CNP , GH , insulin‐like growth factor‐I, leptin and bone‐specific alkaline phosphatase were measured. Anthropometrics were obtained. Results Plasma levels of both CNP and NT pro CNP reached peak levels 7–28 days after starting rh GH treatment and then declined to intermediate levels through the first year. Plasma NT pro CNP levels after 14 days trended towards a correlation with height velocity after 6 and 12 months of treatment. Unexpectedly, serum GH levels measured 2 and 28 days after starting rh GH correlated strongly with height velocity after 6 and 12 months of treatment. Conclusions This study identified 14 days after starting rh GH treatment as the optimal time for assessing CNP and NT pro CNP levels as biomarkers of rh GH efficacy. Additionally, we identified GH levels as a potential biomarker. Larger, prospective studies are now needed to test the clinical utility of these biomarkers.