[Response to 3 years of growth hormone therapy in small for gestational age children: clinical, hormonal and metabolic parameters].
OBJECTIVE
To analyze the effectiveness and safety of growth hormone (GH) treatment, administered over a 3 year period to children small for gestational age (SGA) without catch-up growth, followed up in the Department of Endocrinology at the University Hospital Niño Jesús in Madrid between 2003 and 2011.


METHODS
Anthropometric and analytical data from 52 SGA patients receiving GH therapy (mean dose: 0.035mg/kg/day) were retrospectively examined in order to determine its influence on linear growth, body composition, bone maturation, carbohydrate and lipid metabolism, thyroid hormone profile and blood pressure.


RESULTS
GH treatment induced a significant increase in growth velocity, with the highest rise occurring during the first 12 months of its administration and in children under 5 years of age. Insulin-like growth factor-I levels increased significantly, along with a significant acceleration in bone maturation, with both parameters remaining within normal limits. A progressive rise in fasting glucose levels, glycosylated hemoglobin, baseline insulin, and homeostasis model assessment index, were also found. Low density lipoprotein cholesterol (LDL-c) levels decreased and high density lipoprotein cholesterol levels (HDL-c) increased significantly. The atherogenic ratios of total-cholesterol/HDL-c and LDL-c/HDL-c also decreased significantly.


CONCLUSIONS
GH treatment promotes physical growth in SGA patients, generates certain resistance to the action of insulin, and improves atherogenic risk ratios after 3 years of therapy. Long-term monitoring is required until adult height is reached.
Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
M
M
Güemes Hidalgo
N
N
Fernández de Larrea Baz
M T
MT
Muñoz Calvo
J
J
Argente
D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000187:drug effects*; D019382:Human Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000378:metabolism*; D008297:Male; D012189:Retrospective Studies; D013963:Thyroid Hormones / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D013963:Thyroid Hormones; D019382:Human Growth Hormone