Risk factors for diabetes mellitus type 2 and metabolic syndrome are comparable for previously growth hormone-treated young adults born small for gestational age (sga) and untreated short SGA controls.
BACKGROUND
Low birth weight might increase risk of diabetes mellitus type 2 and metabolic syndrome (MS). GH has insulin-antagonistic properties. Therefore, long-term follow-up of GH-treated children born small for gestational age (SGA) is important.


OBJECTIVE
The objective of the study was to evaluate insulin sensitivity (Si) and disposition index (DI), all components of the MS and IGF-I and IGF binding protein (IGFBP)-3 levels in 37 previously GH-treated young SGA adults in comparison with 25 untreated short SGA controls.


RESULTS
GH-treated subjects were 22.3 (1.7) yr old. Mean duration of GH treatment had been 7.3 (1.3) yr. Mean period after discontinuation was 6.5 (1.4) yr. Si and DI were comparable for GH-treated and untreated SGA subjects. Fasting glucose and insulin levels increased during GH treatment but recovered after discontinuation. Body mass index, waist circumference, high-density lipoprotein cholesterol levels, and triglycerides were equivalent. Systolic and diastolic blood pressure and cholesterol were significantly lower in GH-treated subjects. Thirty-two percent of untreated controls vs. none of the GH-treated subjects had an increased blood pressure. GH-induced rises in IGF-I and IGFBP-3 levels had completely recovered after GH stop.


CONCLUSIONS
At 6.5 yr after discontinuation of long-term GH treatment, Si, DI, fasting levels of glucose and insulin, body mass index, waist circumference, and IGF-I and IGFBP-3 levels were equivalent for GH-treated and untreated young SGA adults. Systolic and diastolic blood pressure and serum cholesterol were even lower in GH-treated subjects. These data are reassuring because they suggest that long-term GH treatment does not increase the risk for diabetes mellitus type 2 and MS in young adults.
van Dijk
Marije
M
Erasmus Medical Center, Sophia Children's Hospital, Department of Pediatrics, Division of Endocrinology, sb-2603, PO Box 2060, 3000 CB Rotterdam, The Netherlands. m.vandijk.1@erasmusmc.nl
Bannink
Ellen M N
EM
van Pareren
Yvonne K
YK
Mulder
Paul G H
PG
Hokken-Koelega
Anita C S
AC
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000378:metabolism; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007333:Insulin Resistance; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D012307:Risk Factors; D049629:Waist-Hip Ratio
D018972:Insulin-Like Growth Factor Binding Protein 3; D008055:Lipids; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D005947:Glucose