Long-term effects of growth hormone (GH) treatment on body composition and bone mineral density in short children born small-for-gestational-age: six-year follow-up of a randomized controlled GH trial.
Context Alterations in the GH-IGF-I axis in short small-for-gestational-age (SGA) children might be associated with abnormalities in bone mineral density (BMD) and body composition. In addition, birth weight has been inversely associated with diabetes and cardiovascular disease in adult life. Data on detailed body composition in short SGA children and long-term effects of GH treatment are very scarce.


OBJECTIVE
To investigate effects of long-term GH treatment on body composition and BMD by dual energy X-ray absorptiometry (DXA) in short SGA children.


METHODS
Longitudinal 6-year GH study with a randomized controlled part for 3 years.


RESULTS
At baseline, fat percentage standard deviation score (SDS) and lumbar spine BMD SDS corrected for height (BMAD(LS) SDS) were significantly lower than zero. Lean body mass (LBM) SDS adjusted for age was also reduced, but LBM adjusted for height (LBM SDS(height)) was not decreased. GH treatment induced a decrease in fat percentage SDS and an increase in BMAD(LS) SDS. LBM SDS(height) remained similar in GH-treated children, but deteriorated in untreated controls. When these untreated controls subsequently started GH treatment, their LBM SDS(height) rapidly normalized to values comparable with zero.


CONCLUSIONS
During long-term GH treatment in short SGA children, fat percentage SDS decreased and BMAD(LS) SDS increased. These effects of GH treatment were most prominent in children who started treatment at a younger age and in those with greater height gain during GH treatment. LBM SDS(height )remained around 0 SDS in GH-treated children, but declined to low normal values in untreated controls.
Willemsen
Ruben H
RH
Department of Pediatrics, Division of Endocrinology, Erasmus MC Sophia, Rotterdam, The Netherlands. r.h.willemsen@erasmusmc.nl
Arends
Nicolette J T
NJ
Bakker-van Waarde
Willie M
WM
Jansen
Maarten
M
van Mil
Edgar G A H
EG
Mulder
Jaap
J
Odink
Roelof J
RJ
Reeser
Maarten
M
Rongen-Westerlaken
Ciska
C
Stokvis-Brantsma
Wilhelmina H
WH
Waelkens
Johan J J
JJ
Hokken-Koelega
Anita C S
AC
D015502:Absorptiometry, Photon; D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008159:Lumbar Vertebrae; D008297:Male; D013995:Time
D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I