High-dose growth hormone treatment of short children born small for gestational age.
The effect of GH administration was evaluated over 2 yr in 50 short, prepubertal, non-GH deficient children born small for gestational age, who had been randomly allocated to a group receiving no treatment or daily sc GH treatment at a dose of 0.2 or 0.3 IU/kg. At the start of the study, mean age was 5.2 yr, bone age was 4.0 yr, height SDS was -3.5, height velocity SDS was -0.8, weight SDS was -2.7, and body mass index SDS was -1.9. Catch-up growth was observed in none of the untreated and all of the treated children. The response to GH treatment included a near doubling of growth velocity and of weight gain and a mean height increment of more than 2 SDS. GH treatment was associated with a distinct acceleration of bone maturation. The differences between the growth responses evoked by the two GH doses were minor. The prepubertal GH-induced catch-up growth was associated with elevated serum concentrations of insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-3, and osteocalcin, whereas insulin-like growth factor-II levels remained unaltered. GH treatment was well tolerated. In conclusion, high-dose GH administration over 2 yr is emerging as a potential therapy to increase the short stature that results from insufficient catch-up growth in young children born small for gestational age. The long-term impact of this approach remains to be delineated.
de Zegher
F
F
Belgian Study Group for Pediatric Endocrinology, Department of Pediatrics, University of Leuven, Belgium.
Maes
M
M
Gargosky
S E
SE
Heinrichs
C
C
Du Caju
M V
MV
Thiry
G
G
De Schepper
J
J
Craen
M
M
Breysem
L
L
Löfström
A
A
Jönsson
P
P
Bourguignon
J P
JP
Malvaux
P
P
Rosenfeld
R G
RG
D000365:Age Determination by Skeleton; D001827:Body Height; D002675:Child, Preschool; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D013006:Growth Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D015675:Osteocalcin / Q000097:blood; D015430:Weight Gain
D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D015675:Osteocalcin; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone