Nutrients & Hormones: Effects in Boys with Disordered Growth

Nelly Mauras, Principal Investigator

Funding: Genentech Center for Clinical Research in Endocrinology

Constitutional delay of growth and maturation (CDGM) describes the condition of poor growth and delayed puberty in an otherwise healthy child. CDGM is one of the most common causes of short stature. Although most children with CDGM will eventually reach normal adult height, many still fall at the lower limits of their mid-parental target height. The underlying etiology of CDGM remains unknown and is likely multifactorial. The role that nutrition plays in this condition has not been adequately investigated. Preliminary data suggest that a mismatch between intake and expenditure explains, at least in part, the poor growth (both linear and ponderal) in this condition. This is a randomized trial of prepubertal boys with CDGM, comparing either growth hormone therapy alone for 18 months and aggressive nutritional supplementation alone for 6 months, followed by 12 months of combined therapy. We will assess dietary intake, total energy expenditure (doubly labeled water), growth, body composition, bone mineral density, and biochemical markers of growth and nutrition. This study will offer a unique insight into the role of nutrition in the in vivo actions of GH.