title: Insulin sensitivity decreases in short children born small for gestational age treated with growth hormone.
abstract: OBJECTIVE
  To evaluate insulin sensitivity in short children born small for gestational age (SGA) treated with growth hormone (GH), and to study the relationship between growth response and insulin levels.
  
  
  METHODS
  In 29 children (16 female, 13 male) who were short and SGA, an oral glucose tolerance test was performed before (mean age, 8.8 years; range, 4.5-14.3 years) and after 1 year of GH treatment (33 microg/kg/day). Insulin sensitivity was calculated with the homeostasis model assessment (HOMA) and the insulin sensitivity index (ISI) of Matsuda.
  
  
  RESULTS
  The mean height increased from -3.1 to -2.4 SD. Insulin resistance (ISI<5) was seen in 17.2% of children before and in 48.3% (mainly pubertal) children after GH treatment. Insulin sensitivity decreased significantly: ISI fell from 12.2 to 6.1 (P= .02) and HOMA increased from 1.2 to 2.2 (P= .001). Glucose and HbA1c levels did not change significantly. ISI after 1 year did not correlate with height gain, but it did correlate with age (r= -0.469; P= .01) and body mass index (r= -0.52; P= .004).
  
  
  CONCLUSIONS
  Insulin sensitivity is impaired in some children who are SGA already at baseline and decreases with GH treatment in most of them. Children close to puberty and children who are less underweight have the highest risk to become insulin resistant.
authors.affiliation: Division of Endocrinology and Diabetology, University Children's Hospital, Munich, Germany.
authors.forename: Sara
authors.initials: S
authors.lastname: Bachmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Bechtold
authors.forename: Walter
authors.initials: W
authors.lastname: Bonfig
authors.forename: Stephanie
authors.initials: S
authors.lastname: Putzker
authors.forename: Matthias
authors.initials: M
authors.lastname: Buckl
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005951:Glucose Tolerance Test; D006128:Growth / Q000187:drug effects / Q000502:physiology; D006130:Growth Disorders / Q000150:complications / Q000188:drug therapy*; D013006:Growth Hormone / Q000009:adverse effects*; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007333:Insulin Resistance; D008297:Male
chemical_list: D001786:Blood Glucose; D013006:Growth Hormone