Direct and indirect effects of Growth Hormone Deficiency (GHD) on lung function in children: A mediation analysis

Nicola Scichilone, Carla Giordano, Giuliana Ferrante, Salvatore Fasola, Giovanna Cilluffo, Stefania La Grutta, Giancarlo Tancredi, Giovanni Viegi

Risultato della ricerca: Article

1 Citazione (Scopus)

Abstract

Background: Studies on pulmonary function tests (PFTs) in Growth Hormone Deficiency (GHD) children are lacking. The aims of this study were: (i) to investigate PFTs in GHD pre-pubertal children with respect to Controls, before starting Growth Hormone Therapy (GHT) (T0); (ii) to evaluate changes of PFTs in GHD vs Controls, after 1-year GHT (T1). Forboth aims the mediation analysis (MA) was applied to evaluate the extent to which the relationship between GHD and PFTs could be ascribed to a height-mediated (indirect) or a GH direct effect. Methods: 47 pre-pubertal GHD children (aged 5–14 years) underwent PFTs at T0 and T1. At T0, 47 healthy children matched for age and sex were enrolled as Controls. A MA was performed to assess the relationship between GHD and PFTs and height. Statistical analyses were performed using the statistical software R (https:// cran.r-project.org/mirrors.html). A p-value<0.05 was considered significant. Measurements and main results: At T0, PFTs indices were significantly lower in GHD than in Controls. From T0 to T1 a significant improvement was found in PFTs. The percentages of the mediated effect on FVC, FEV1, FEF25–75% and TLC were<50% at T0, suggesting that the direct effect was prevalent. At T1, the percentages of the mediated effect for spirometry indices were ≥50%, indicating that the indirect (height-mediated) effect was the most relevant. Conclusions: The study shows that pre-pubertal children with GHD have an impairment of lung function not exclusively attributable to the indirect (height-mediated) effect, but also to the direct GH action which is mitigated after 1-year of GHT.
Lingua originaleEnglish
pagine (da-a)61-69
Numero di pagine9
RivistaRespiratory Medicine
Volume137
Stato di pubblicazionePublished - 2018

Fingerprint

Growth Hormone
Respiratory Function Tests
Lung
Spirometry
Therapeutics
Software

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cita questo

Direct and indirect effects of Growth Hormone Deficiency (GHD) on lung function in children: A mediation analysis. / Scichilone, Nicola; Giordano, Carla; Ferrante, Giuliana; Fasola, Salvatore; Cilluffo, Giovanna; La Grutta, Stefania; Tancredi, Giancarlo; Viegi, Giovanni.

In: Respiratory Medicine, Vol. 137, 2018, pag. 61-69.

Risultato della ricerca: Article

Scichilone, Nicola ; Giordano, Carla ; Ferrante, Giuliana ; Fasola, Salvatore ; Cilluffo, Giovanna ; La Grutta, Stefania ; Tancredi, Giancarlo ; Viegi, Giovanni. / Direct and indirect effects of Growth Hormone Deficiency (GHD) on lung function in children: A mediation analysis. In: Respiratory Medicine. 2018 ; Vol. 137. pagg. 61-69.
@article{33e0da6521584727aa7337dbbaac6217,
title = "Direct and indirect effects of Growth Hormone Deficiency (GHD) on lung function in children: A mediation analysis",
abstract = "Background: Studies on pulmonary function tests (PFTs) in Growth Hormone Deficiency (GHD) children are lacking. The aims of this study were: (i) to investigate PFTs in GHD pre-pubertal children with respect to Controls, before starting Growth Hormone Therapy (GHT) (T0); (ii) to evaluate changes of PFTs in GHD vs Controls, after 1-year GHT (T1). Forboth aims the mediation analysis (MA) was applied to evaluate the extent to which the relationship between GHD and PFTs could be ascribed to a height-mediated (indirect) or a GH direct effect. Methods: 47 pre-pubertal GHD children (aged 5–14 years) underwent PFTs at T0 and T1. At T0, 47 healthy children matched for age and sex were enrolled as Controls. A MA was performed to assess the relationship between GHD and PFTs and height. Statistical analyses were performed using the statistical software R (https:// cran.r-project.org/mirrors.html). A p-value<0.05 was considered significant. Measurements and main results: At T0, PFTs indices were significantly lower in GHD than in Controls. From T0 to T1 a significant improvement was found in PFTs. The percentages of the mediated effect on FVC, FEV1, FEF25–75{\%} and TLC were<50{\%} at T0, suggesting that the direct effect was prevalent. At T1, the percentages of the mediated effect for spirometry indices were ≥50{\%}, indicating that the indirect (height-mediated) effect was the most relevant. Conclusions: The study shows that pre-pubertal children with GHD have an impairment of lung function not exclusively attributable to the indirect (height-mediated) effect, but also to the direct GH action which is mitigated after 1-year of GHT.",
author = "Nicola Scichilone and Carla Giordano and Giuliana Ferrante and Salvatore Fasola and Giovanna Cilluffo and {La Grutta}, Stefania and Giancarlo Tancredi and Giovanni Viegi",
year = "2018",
language = "English",
volume = "137",
pages = "61--69",
journal = "Respiratory Medicine",
issn = "0954-6111",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Direct and indirect effects of Growth Hormone Deficiency (GHD) on lung function in children: A mediation analysis

AU - Scichilone, Nicola

AU - Giordano, Carla

AU - Ferrante, Giuliana

AU - Fasola, Salvatore

AU - Cilluffo, Giovanna

AU - La Grutta, Stefania

AU - Tancredi, Giancarlo

AU - Viegi, Giovanni

PY - 2018

Y1 - 2018

N2 - Background: Studies on pulmonary function tests (PFTs) in Growth Hormone Deficiency (GHD) children are lacking. The aims of this study were: (i) to investigate PFTs in GHD pre-pubertal children with respect to Controls, before starting Growth Hormone Therapy (GHT) (T0); (ii) to evaluate changes of PFTs in GHD vs Controls, after 1-year GHT (T1). Forboth aims the mediation analysis (MA) was applied to evaluate the extent to which the relationship between GHD and PFTs could be ascribed to a height-mediated (indirect) or a GH direct effect. Methods: 47 pre-pubertal GHD children (aged 5–14 years) underwent PFTs at T0 and T1. At T0, 47 healthy children matched for age and sex were enrolled as Controls. A MA was performed to assess the relationship between GHD and PFTs and height. Statistical analyses were performed using the statistical software R (https:// cran.r-project.org/mirrors.html). A p-value<0.05 was considered significant. Measurements and main results: At T0, PFTs indices were significantly lower in GHD than in Controls. From T0 to T1 a significant improvement was found in PFTs. The percentages of the mediated effect on FVC, FEV1, FEF25–75% and TLC were<50% at T0, suggesting that the direct effect was prevalent. At T1, the percentages of the mediated effect for spirometry indices were ≥50%, indicating that the indirect (height-mediated) effect was the most relevant. Conclusions: The study shows that pre-pubertal children with GHD have an impairment of lung function not exclusively attributable to the indirect (height-mediated) effect, but also to the direct GH action which is mitigated after 1-year of GHT.

AB - Background: Studies on pulmonary function tests (PFTs) in Growth Hormone Deficiency (GHD) children are lacking. The aims of this study were: (i) to investigate PFTs in GHD pre-pubertal children with respect to Controls, before starting Growth Hormone Therapy (GHT) (T0); (ii) to evaluate changes of PFTs in GHD vs Controls, after 1-year GHT (T1). Forboth aims the mediation analysis (MA) was applied to evaluate the extent to which the relationship between GHD and PFTs could be ascribed to a height-mediated (indirect) or a GH direct effect. Methods: 47 pre-pubertal GHD children (aged 5–14 years) underwent PFTs at T0 and T1. At T0, 47 healthy children matched for age and sex were enrolled as Controls. A MA was performed to assess the relationship between GHD and PFTs and height. Statistical analyses were performed using the statistical software R (https:// cran.r-project.org/mirrors.html). A p-value<0.05 was considered significant. Measurements and main results: At T0, PFTs indices were significantly lower in GHD than in Controls. From T0 to T1 a significant improvement was found in PFTs. The percentages of the mediated effect on FVC, FEV1, FEF25–75% and TLC were<50% at T0, suggesting that the direct effect was prevalent. At T1, the percentages of the mediated effect for spirometry indices were ≥50%, indicating that the indirect (height-mediated) effect was the most relevant. Conclusions: The study shows that pre-pubertal children with GHD have an impairment of lung function not exclusively attributable to the indirect (height-mediated) effect, but also to the direct GH action which is mitigated after 1-year of GHT.

UR - http://hdl.handle.net/10447/291442

M3 - Article

VL - 137

SP - 61

EP - 69

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

ER -