First two years' response to growth hormone treatment in very young preterm small for gestational age children.
BACKGROUND
Growth hormone (GH) is a therapeutic option for small for gestational age (SGA) children without spontaneous catch-up. There are few reports on preterm SGA children. Prematurity is an additional risk factor for adult short stature.


OBJECTIVE
To describe GH efficacy in preterm SGA patients.


METHODS
Twenty-five preterm SGA patients, 2-4 years old, treated with GH 0.066 mg/kg/day, were compared with 14 age-matched preterm SGA historical controls. Height, weight, IGF-I, IGFBP-3, fasting glucose and insulin were measured every 6 months.


RESULTS
At start of GH treatment, mean height and weight were -2.4 and -2.4 SDS, respectively. There was a significant increment in height SDS of 1.3 and 2.1 during the 1st and the 2nd year of GH therapy, respectively. There was no significant difference between the progression of chronological and bone ages. A significant increase in IGF-I, IGFBP-3 and molar ratio was observed during GH therapy. There was no difference in glucose, insulin or HOMA-IR index.


CONCLUSIONS
We showed for the first time that the height increment of preterm SGA with GH treatment is similar to that described in other studies with term SGA patients. Therefore, short-term GH treatment in a subset of preterm SGA patients between 2-4 years of age was able to promote adequate growth recovery with no excessive bone age acceleration or adverse effects on carbohydrate metabolism.
Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de São Paulo Faculty of Medical Sciences, São Paulo, Brazil.
R A M
RA
Garcia
C A
CA
Longui
C
C
Kochi
M
M
Arruda
C D C
CD
Faria
L E P
LE
Calliari
O
O
Monte
P R
PR
Pachi
P
P
Saenger
D000365:Age Determination by Skeleton; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D002675:Child, Preschool; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use
C032231:IGFBP1 protein, human; C515497:IGFBP3 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; D011994:Recombinant Proteins; D019382:Human Growth Hormone