title: Metabolic impact of growth hormone treatment in short children born small for gestational age.
abstract: BACKGROUND
  Growth hormone (GH) treatment in short children born small for gestational age (SGA) may result in metabolic changes with potential long-term effects.
  
  
  METHODS
  149 short SGA children (mean birth weight 2.0 ± 0.6 kg, age 5.5 ± 1.5 years, height standard deviation score (SDS) -3.1 ± 0.6) were randomised to: low-dose GH therapy (0.033 mg/kg/day) for 2 years; high-dose GH therapy (0.100 mg/kg/day) for 1 year, or mid-dose GH therapy (0.067 mg/kg/day) for 1 year. Leptin, ghrelin, insulin-like growth factor-I (IGF-I), IGF binding protein-1 (IGFBP-1), lipids, fasting blood glucose and fasting insulin were assessed at baseline, 12 and 24 months.
  
  
  RESULTS
  After 1 year of active treatment, GH significantly reduced serum ghrelin and increased IGF-I SDS and insulin levels. Regression analysis showed an inverse correlation between ghrelin and IGF-I SDS (p < 0.001). Leptin and IGFBP-1 also declined (both p < 0.05). Changes in insulin levels reversed upon discontinuation. Improvements in lipid profile were nonsignificant and fasting blood glucose levels remained within the normal range.
  
  
  CONCLUSIONS
  In short SGA children, ghrelin and leptin reductions associated with GH treatment may occur through a negative feedback loop of the GH-IGF-I axis. Consequently, via ghrelin and leptin suppression, GH treatment may modify food intake and body composition and potentially improve long-term metabolic outcomes.
authors: Department of Pediatrics, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Jan
authors: J
authors: Lebl
authors: Yael
authors: Y
authors: Lebenthal
authors: Stanislava
authors: S
authors: Kolouskova
authors: Adam
authors: A
authors: Steensberg
authors: Kirsten
authors: K
authors: Jøns
authors: Anne-Marie
authors: AM
authors: Kappelgaard
authors: Lourdes
authors: L
authors: Ibáñez
authors: Moshe
authors: M
authors: Phillip
mesh_terms: D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D054439:Ghrelin / Q000378:metabolism; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D008297:Male
chemical_list: D054439:Ghrelin; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1; D020738:Leptin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I