Growth hormone secretion in sickle cell patients

It is not known if the somatic growth retardation in sickle cell disease is associated with inadequate secretion of growth hormone (GH). We have therefore compared GH concentration (mean ± S.D.) in adolescent and young adult normals and sicklers. The mean basal serum concentration of GH in adolescent sicklers (6.6 ± 2.7 μg/ml) was significantly lower (P < 0.01) than the mean value for the normal adolescents (15.0 ± 2.2 μg/ml). Unlike the adolescents, the young adult sicklers had a significantly higher (P < 0.05) mean (10.3 ± 4.8 μg/ml) than the normal young adults (7.0 ± 3.4 μg/ml). Serum GH reaches maximum levels between 12 and 18 years and then there is a decline. This trend was seen in the normals but not in the sicklers. The mean GH level in the adolescent sicklers was significantly lower (P < 0.05) than in the young sicklers. The departure from the normal pattern is significant but difficult to explain. It is important to note that at a time when they need a lot of circulating GH for the adolescent growth spurt, the adolescent sicklers had significantly less than normal mean GH concentration. This finding, coupled with reduced testosterone level and poor nitrogen economy reported elsewhere may account for the somatic growth retardation of sicklers.