Adherence to growth hormone (GH) therapy in naïve to treatment GH-deficient children: data of the Italian Cohort from the Easypod Connect Observational Study (ECOS).

BACKGROUND: With the use of non-objective measurement, adherence to growth hormone (GH) therapy has been reported suboptimal in a large proportion of patients, and poor adherence has been shown to affect short-term growth response in patients receiving GH treatment. OBJECTIVE: The Easypod™ electronic device allows objective measurement of adherence. In this study, we report 3-year prospective adherence data of the Italian cohort of naïve GH deficient (GHD) children extrapolated from the Easypod Connect Observational Study (ECOS) database. PATIENTS AND METHODS: Seventy-three GHD children naïve to GH treatment were included in the analysis. 22 Italian centers participated in the study. RESULTS: Mean adherence rate was consistently above 85% across the 3-year observation period. Particularly, mean adherence was 88.5%, 86.6%, and 85.7% after 1, 2 and 3 years, respectively. Mean (± SD) height-SDS increase after the first year was 0.41 (± 0.38). CONCLUSIONS: The majority of naïve GHD children starting GH treatment with Easypod maintained an adherence rate > 85% up to 3 years. Easypod is a useful tool to follow-up patients' adherence allowing timely intervention to improve optimal treatment for these patients.

Correlation between cortisol and components of the metabolic syndrome in obese children and adolescents.

BACKGROUND: In obese subjects it has been shown that cortisol (F) contributes to the reduction in insulin sensitivity, suggesting a role in the development of the metabolic syndrome (MS). AIM: The aim of this retrospective study was to evaluate the relationship between F and components of MS in 1,027 obese children and adolescents. SUBJECTS AND METHODS: Waist circumference, systolic and diastolic blood pressure (SP, DP), F, serum glucose (Glyc), cholesterol HDL, triglycerides and homeostatic model assessment (HOMA index) were evaluated in all subjects. MS was defined according to the International Diabetes Federation criteria. Accordingly, patients were subdivided into three age groups: 6-10, 10-16 and >16 years. RESULTS: In univariate regression analysis, F was correlated with Glyc, SP and HOMA in groups 1 and 2, with DP in Group 2. In multivariate regression analysis including age, sex, puberty, BMI-SDS and F as independent variables and one of the component of the MS as the dependent variable, F was a weak predictor of the variability when DP and Glyc were introduced as dependent variables in Group 2 and when SP was introduced as dependent variable both in groups 1 and 2. When patients were subdivided into subgroups according to the IDF criteria, in Group 2 patients with one or more components of the MS had higher F concentrations. CONCLUSIONS: In this cohort of obese children and adolescents, F was weakly associated with components of the MS. These findings do not support a major role for F in the development of MS.