Journal Article

Insulin Sensitivity Modulates the Growth Response during the First Year of High-Dose Growth Hormone Treatment in Short Prepubertal Children Born Small for Gestational Age

Rooman, Raoul, Massa, Guy, Thomas, Muriel, de Beaufort, Carine, Beckers, Dominique, Tenoutasse, Sylvie, Gies, Inge, De Schepper, Jean, De Waele, Kathleen, Lebrethon, Marie-Christine, Francois, Inge, Maes, Marc

2012

Overview

Aim: To study the relationship between insulin sensitivity and growth response in short children born small for gestational age (SGA) treated with growth hormone (GH). Methods: Randomized, open-label, 24-month intervention study in 40 short prepubertal SGA children [age (mean ± SD) 5.3 ± 1.5 years], who either remained untreated (n = 20) or were treated with GH (66 µg/kg/day; n = 20). Changes in fasting glucose, insulin, quantitative insulin sensitivity check index (QUICKI), IGF-1 and leptin after 1 and 2 years were studied. Results: Mean height SDS increased from –3.3 ± 0.7 to –2.3 ± 0.7 after 1 year, and to –1.9 ± 0.7 after 2 years of treatment. QUICKI decreased significantly (p = 0.008) in the first year of GH treatment and stabilized in the second year. Baseline QUICKI was positively associated (r = 0.40; p < 0.05) with the change in height SDS in the first year. Conclusion: Higher insulin sensitivity at the start of GH therapy is associated with greater first-year growth response to GH, and could be a promising parameter in selecting prepubertal short SGA children for GH treatment. However, this finding needs to be confirmed in larger studies.

• Publisher: S. Karger AG,Karger
• Subject: Age Factors / Body Height / Body Height - drug effects / Body Height - physiology / Body Height/drug effects/physiology / Child / Child Development / Child Development - drug effects / Child Development - physiology / Child Development/drug effects/physiology / Child, Preschool / Diabétologie / Dose-Response Relationship, Drug / Endocrinologie / Female / gestational age / Growth / Growth Disorders / Growth Disorders - drug therapy / Growth Disorders - metabolism / Growth Disorders/drug therapy/metabolism / Growth Hormone / Growth hormone treatment / Human Growth Hormone / Human Growth Hormone - therapeutic use / Human health sciences / Humans / Infant, Newborn / Infant, Small for Gestational Age / Infant, Small for Gestational Age - growth & development / Infant, Small for Gestational Age - metabolism / Infant, Small for Gestational Age/growth & development/metabolism / insulin resistance / Insulin Resistance - physiology / insulin sensitivity / Leptin / Male / Multidisciplinaire, généralités & autres [D99] [Sciences de la santé humaine] / Multidisciplinary, general & others [D99] [Human health sciences] / Métabolisme / Original Paper / Pediatrics / puberty / Puberty - metabolism / Puberty - physiology / Puberty/metabolism/physiology / Pédiatrie / Sciences de la santé humaine / SGA / small children / Small for gestational age / Time Factors / treatment / Treatment Outcome