title: High-dose growth hormone treatment of short children born small for gestational age.
abstract: 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.
authors.affiliation: Belgian Study Group for Pediatric Endocrinology, Department of Pediatrics, University of Leuven, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: de Zegher
authors.forename: M
authors.initials: M
authors.lastname: Maes
authors.forename: S E
authors.initials: SE
authors.lastname: Gargosky
authors.forename: C
authors.initials: C
authors.lastname: Heinrichs
authors.forename: M V
authors.initials: MV
authors.lastname: Du Caju
authors.forename: G
authors.initials: G
authors.lastname: Thiry
authors.forename: J
authors.initials: J
authors.lastname: De Schepper
authors.forename: M
authors.initials: M
authors.lastname: Craen
authors.forename: L
authors.initials: L
authors.lastname: Breysem
authors.forename: A
authors.initials: A
authors.lastname: Löfström
authors.forename: P
authors.initials: P
authors.lastname: Jönsson
authors.forename: J P
authors.initials: JP
authors.lastname: Bourguignon
authors.forename: P
authors.initials: P
authors.lastname: Malvaux
authors.forename: R G
authors.initials: RG
authors.lastname: Rosenfeld
mesh_terms: 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
chemical_list: 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