Growth Hormone Deficiency, Small-for-gestational Age
Conditions
Keywords
endothelial dysfunction, doppler ultrasound examination, nitric oxide
Brief summary
Principal objective : Validation of a handy biochemical parameter, plasma concentration of Asymmetric DimethylArginine (ADMA), based on a recognize biochemical parameter, the dilation of the brachial artery, at ultrasound examination, after the deflation of a cushion to evaluate artery dysfunction (vascular suffering) in growth diseases, growth hormone deficiency (GHD) and intrauterine growth retardation (IUGR) Secondary objectives: * Comparison of ADMA plasma concentrations with dose of matched healthy control children * Investigation of the mechanisms of arterial dysfunction, inflammation, oxidative stress and insulin resistance.
Interventions
DIAGNOSTIC_TESTarterial doppler ultrasound
doppler ultrasound
Sponsors
University Hospital, Lille
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
3 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Group A: GHD, defined by 2 GH peaks less than 6.6 ng/ml (20 mU/L) at two stimulation tests * Group B: IUGR, defined by a birth length and/or a birth weight inferior to - 2 SD for gestational age according to Usher and McLean charts * Group C: Control children matched to children matched to subjects of groups A and B, according to gender and age * Informed consent signed by representative of the parental authority
Exclusion criteria
* Chronic disabling disease (ex: diabetes, severe asthma) * Evolving cancer * Severe psychiatric disorder (ex: autism, schizophrenia; severe depression) * Hypothalamic tumor (ex: craniopharyngioma) * Anamnesis of cranial irradiation * Overweight, obesity or thinness * Precocious puberty * Non-replacing therapy by glucocorticoids or sex steroids less than 1 month before the exploration * Anterior treatment by recombinant human GH * Other conditions, treatments or habits impacting arterial reactivity: acrocyanosis, cryoglobulinemia, beta adrenergic blocking habits, tobacco smoking or other drug addictions, dyslipidemia * Pregnancy or lactation * Acute infection less than three weeks before the investigation * Participation to a therapeutic protocol * Impossibility for the representatives of the parental authority to understand the objectives of the protocol * Absence of social security coverage. Refusal by the parents to sign the informed consent or oral refusal by the child to participate to the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma Asymmetric Dimethylarginine (ADMA) | At baseline | Correlation between ADMA (Asymmetric DimethylArginine, a collateral derivate of nitric oxide metabolism) levels and the percentage of dilation of the brachial artery at Doppler ultrasound examination. The dosage will be performed by high pressure liquid chromatography followed by tandem mass spectrometry (HPLC-MS / MS) |
| Percentage of dilation of the brachial artery at Doppler ultrasound examination. | At baseline. | Correlation between ADMA (Asymmetric DimethylArginine, a collateral derivate of nitric oxide metabolism) levels and the percentage of dilation of the brachial artery at Doppler ultrasound examination. |
Secondary
| Measure | Time frame |
|---|---|
| Difference of ADMA concentration between the patient and the control groups | At baseline |
| Correlation of ADMA levels with diverse cardiovascular risk factors | At baseline |
Countries
France
Outcome results
None listed