Reduced insulin sensitivity during growth hormone therapy for short children born small for gestational age.
OBJECTIVE
To examine the influence of recombinant human growth hormone (rhGH) therapy on insulin sensitivity in short children born small for gestational age (SGA).


METHODS
Twelve short (height standard deviation score, -3.2 +/- 0.1) non-GH-deficient children SGA (7 boys/5 girls) were studied at 9.3 +/- 1.0 years of age. The insulin sensitivity index was measured with Bergman's minimal model before (11 children) and during (12 children) rhGH therapy (21 +/- 6 months) administered daily at 20 IU/m(2) per week. No child had a change in pubertal status during the study. In addition, 5 children who remained prepubertal had insulin sensitivity remeasured 3 months after rhGH therapy was suspended.


RESULTS
With rhGH therapy, insulin sensitivity fell 44% +/- 10% (P =.018), with a compensatory rise in the acute insulin response of 123% +/- 59% (P <.009). Reassessment of insulin sensitivity in 5 children (3 boys/2 girls) 3 months after suspension of rhGH occurred at 9.9 +/- 0.7 years. Insulin sensitivity remained unchanged after rhGH therapy was stopped: 31.6 (20.5-42.3) before treatment, 11.5 (5.7-24.4) with treatment, and 10.7 (6.2-16.9) 10(-4). min(-1) microU/mL after treatment.


CONCLUSIONS
Children SGA are known to have reduced insulin sensitivity. There was a further reduction in insulin sensitivity with rhGH therapy that did not recover 3 months after rhGH therapy was stopped.
Cutfield
Wayne S
WS
Department of Paediatrics, the Liggins Institue for Medical Research, University of Auckland, Auckland, New Zealand.
Jackson
Wendy E
WE
Jefferies
Craig
C
Robinson
Elizabeth M
EM
Breier
Bernhard H
BH
Richards
Gail E
GE
Hofman
Paul L
PL
D001786:Blood Glucose / Q000032:analysis; D001827:Body Height / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000378:metabolism*; D013006:Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D020738:Leptin / Q000097:blood; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone