title: Insulin sensitivity modulates the growth response during the first year of high-dose growth hormone treatment in short prepubertal children born small for gestational age.
abstract: OBJECTIVE
  To study the relationship between insulin sensitivity and growth response in short children born small for gestational age (SGA) treated with growth hormone (GH).
  
  
  METHODS
  Randomized, open-label, 24-month intervention study in 40 short prepubertal SGA children [age (mean ± SD) 5.3 ± 1.5 years], who either remained untreated (n = 20) or were treated with GH (66 µg/kg/day; n = 20). Changes in fasting glucose, insulin, quantitative insulin sensitivity check index (QUICKI), IGF-1 and leptin after 1 and 2 years were studied.
  
  
  RESULTS
  Mean height SDS increased from -3.3 ± 0.7 to -2.3 ± 0.7 after 1 year, and to -1.9 ± 0.7 after 2 years of treatment. QUICKI decreased significantly (p = 0.008) in the first year of GH treatment and stabilized in the second year. Baseline QUICKI was positively associated (r = 0.40; p < 0.05) with the change in height SDS in the first year.
  
  
  CONCLUSIONS
  Higher insulin sensitivity at the start of GH therapy is associated with greater first-year growth response to GH, and could be a promising parameter in selecting prepubertal short SGA children for GH treatment. However, this finding needs to be confirmed in larger studies.
authors: Department of Pediatrics, University Hospital, at Brussels (UZ Brussel), Brussels, Belgium. inge.gies@uzbrussel.be
authors: Inge
authors: I
authors: Gies
authors: Muriel
authors: M
authors: Thomas
authors: Sylvie
authors: S
authors: Tenoutasse
authors: Kathleen
authors: K
authors: De Waele
authors: Marie-Christine
authors: MC
authors: Lebrethon
authors: Dominique
authors: D
authors: Beckers
authors: Inge
authors: I
authors: Francois
authors: Marc
authors: M
authors: Maes
authors: Raoul
authors: R
authors: Rooman
authors: Carine
authors: C
authors: de Beaufort
authors: Guy
authors: G
authors: Massa
authors: Jean
authors: J
authors: De Schepper
mesh_terms: D000367:Age Factors; D001827:Body Height / Q000187:drug effects / Q000502:physiology; D002648:Child; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000378:metabolism; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development* / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D011627:Puberty / Q000378:metabolism / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone