title: Efficacy and safety of long-term continuous growth hormone treatment of children born small for gestational age.
abstract: Twelve years of growth hormone (GH) therapy of short children born small for gestational age (SGA) have demonstrated that GH is an effective and well-tolerated therapy. Most children will reach a normal adult height (AH). AH of 55 SGA adolescents was comparable for those treated with a GH dose of 1 or 2 mg/m2 (approximately 0.033 or 0.066 mg/kg) per day, mean (SD) AH SDS being -1.2 (0.7) and -0.8 (0.7), respectively. GH therapy had no influence on the age at onset, the progression of puberty, duration of puberty and pubertal height gain. GH therapy induced higher fasting and glucose-stimulated insulin levels after 1 and 6 years, but 6 months after GH stop, all levels returned to normal. At baseline mean systolic blood pressure was significantly increased, but both systolic and diastolic blood pressure decreased significantly during 6 years of GH and remained so after GH stop. GH therapy demonstrated a beneficial effect on serum lipid profiles, body composition, bone mineral density and head growth. Treatment with 2 mg GH/m2 per day induced mean serum IGF-I levels of +2 SDS, whereas IGF-I levels remained within the normal range with 1 mg GH/m2 per day. In conclusion, long-term GH therapy of short SGA children with 1 mg/m2 per day appears to be effective and safe. Since the future consequences of high serum IGF-I levels during long-term GH therapy with 2 mg/m2 per day are as yet unknown, it seems safer to treat short prepubertal SGA children with a GH dose of 1 mg/m2 per day when children are to be treated continuously for many years.
authors.affiliation: Division of Endocrinology, Department of Paediatrics, Sophia Children's Hospital/Erasmus University Medical Centre, Rotterdam, The Netherlands. a.hokken@erasmusmc.nl
authors.forename: Anita
authors.initials: A
authors.lastname: Hokken-Koelega
authors.forename: Yvonne
authors.initials: Y
authors.lastname: van Pareren
authors.forename: Nicolette
authors.initials: N
authors.lastname: Arends
authors.forename: Venje
authors.initials: V
authors.lastname: Boonstra
mesh_terms: D004334:Drug Administration Schedule; D006130:Growth Disorders / Q000188:drug therapy*; D013006:Growth Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D016896:Treatment Outcome
chemical_list: D013006:Growth Hormone