Angle of trunk rotation in children suffering from growth hormone deficiency

Introduction
Growth hormone deficiency (GHD) can lead to musculoskeletal system defects. Treatment with recombinant human growth hormone (rhGH) in children suffering from GHD increases muscle mass and improves bone structure. The purpose of this study was to evaluate the angle of trunk rotation (ATR) in patients diagnosed with GHD treated with rhGH and to observe the incidence of scoliosis.

Material and methods
The study was conducted among 50 children diagnosed with GHD. The group consisted of 11 girls and 39 boys, aged 6–16 years. The study group included 10 children who had recently qualified for the rhGH treatment and 40 patients undergoing this treatment, with different therapy durations. The angle of trunk rotation was measured using a Bunnell scoliometer. For the purposes of the study, each patient was measured at 5 levels: C7/Th1, Th6, Th12/L1, L3, and L5/S1.

Results
It was noted that in 10% of patients the ATR at the Th6 level was in the range 4-6°, at the Th12/L1 level 10% of children presented abnormalities in the range of 4-6° and at the L3 level 8% of patients, while at the L5/S1 level it was 5% of respondents. One person in the analyzed group (2%) presented ATR above 7° at the Th12/L1 level. Other levels tested in the research group remained within normal range. Girls had greater asymmetries compared to boys. There were no statistically significant differences in ATR comparing patients before hormonal treatment and patients undergoing rhGH treatment. The age of the beginning of the therapy, the duration of rhGH therapy, and body mass index (BMI) had no effect on ATR. Sport activities had a positive impact on the results obtained by scoliometer assessment.

Conclusions
The angle of trunk rotation is higher in growth hormone-deficient females. Weight, height, BMI, the time of growth hormone therapy beginning, and the duration of this therapy do not influence ATR. The more sports activities undertaken, the lower the value of the angle of trunk rotation. Treatment with rhGH does not increase the incidence of scoliosis.