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Function and form of the shoulder in congenital and untreated growth hormone deficiency

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Abstract

Objectives

The shoulder is the most mobile joint in the entire human body. During arm elevation, it requires the integrity of a set of muscles, bones, and tendons. Individuals with short stature often need to raise their arms above the shoulder girdle and may have functional restriction or shoulder injuries. The impact of isolated GH deficiency (IGHD) on joints remains not well defined. The purpose of this work is to evaluate the function and structure of the shoulder in short-statured adult individuals with untreated IGHD due to the same homozygous mutation in the GHRH receptor gene.

Methods

A cross-sectional study (evidence 3) was carried out in 20 GH-naive IGHD subjects and 20 age-matched controls. They completed the disabilities of the arm, shoulder, and hand (DASH) questionnaire and shoulder ultrasound (US). Thickness of the anterior, medial, and posterior portions of the supraspinatus tendon and of subacromial space was measured, and the number of individuals with tendinosis or tearing of the supraspinatus tendon was registered.

Results

DASH score was similar between IGHD and controls, but IGHD subjects complained less of symptoms (p = 0.002). The number of individual with tears was higher in the controls (p = 0.02). As expected, the absolute US measurements were lower in IGHD, but the magnitude of the reduction was most pronounced in the thickness of the anterior portion of the supraspinatus tendon.

Conclusion

Adults with lifetime IGHD do not have functional shoulder restrictions, complain less of problems in performing upper extremity activities, and have fewer tendinous injuries than controls.

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Acknowledgements

The authors would like to thank the Associação do Crescimento Físico e Humano de Itabaianinha, for assistance.

Funding

This work was not supported by public or private funds.

Author contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by HT. S‑J, VMS-A, AAO-S, CSB-O, and MHA-O. Analysis was performed by HT. S‑J, EVM, CRO, VCC, NVM, EGS, FAP, NOS, VOB, and K.R.V-G. The first draft of the manuscript was written by HTS‑Júnior, and MH. AO and the final version was edited by LAO-N and RS. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Division of Orthopedics, Health Sciences Graduate Program, Federal University of Sergipe, 49060–100, Aracaju, Sergipe, Brazil

    Hertz T. Santos Jr

  2. Ultrasound Division, Health Sciences Graduate Program, Federal University of Sergipe, 49060–100, Aracaju, Sergipe, Brazil

    Victor M. Silva-Albuquerque

  3. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, 21287, USA

    Roberto Salvatori

  4. Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060–100, Aracaju, Sergipe, Brazil

    Enaldo V. Melo, Alécia A. Oliveira-Santos, Carla R. P. Oliveira, Viviane C. Campos, Cynthia S. Barros-Oliveira, Nelmo V. Menezes, Elenilde G. Santos, Francisco A. Pereira, Nathalie O. Santana, Vanderlan O. Batista, Keila R. Villar-Gouy & Manuel H. Aguiar-Oliveira

  5. Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil

    Luiz A. Oliveira-Neto

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R. Salvatori serves on Novordisk advisory board.

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Santos, H.T., Silva-Albuquerque, V.M., Salvatori, R. et al. Function and form of the shoulder in congenital and untreated growth hormone deficiency. Endocrine 81, 547–554 (2023). https://doi.org/10.1007/s12020-023-03391-x

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