title: Baseline IGF-I levels determine insulin secretion and insulin sensitivity during the first year on growth hormone therapy in children born small for gestational age. Results from a North European Multicentre Study (NESGAS).
abstract: OBJECTIVE
  Developmental programming alters growth and metabolic outcome in children born small for gestational age (SGA). We explored insulin and glucose metabolism in SGA children treated with a fixed GH dose over 1 year.
  
  
  METHODS
  In the North European Small for Gestational Age Study (NESGAS), 110 short SGA children received GH at 67 µg/kg/day for 1 year. Insulin secretion was assessed by acute insulin response (AIR), insulin sensitivity (IS) by HOMA and disposition index (DI) by insulin secretion adjusted for IS.
  
  
  RESULTS
  First-year GH therapy led to increases in height and IGF-I standard deviation score (SDS), and reductions in IS (p < 0.0001). Compensatory increases in AIR (p < 0.0001) were insufficient and resulted in reduced DI (p = 0.032). Children in the highest IGF-I SDS tertile at baseline were the least insulin sensitive at baseline (p = 0.024) and 1 year (p = 0.006). IGF-I responses after 1 year were positively related to AIR (r = 0.30, p = 0.007) and DI (r = 0.29, p = 0.005).
  
  
  CONCLUSIONS
  In SGA children treated with a high GH dose for 1 year, baseline IGF-I levels were related to IS whilst gains in height and IGF-I responses were associated with insulin secretion. Defining heterogeneity in IGF-I in SGA children may be useful in predicting growth and metabolic response.
authors.affiliation: Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark. rikke.beck@dadlnet.dk
authors.forename: Rikke Beck
authors.initials: RB
authors.lastname: Jensen
authors.forename: Ajay
authors.initials: A
authors.lastname: Thankamony
authors.forename: Susan M
authors.initials: SM
authors.lastname: O'Connell
authors.forename: Burak
authors.initials: B
authors.lastname: Salgin
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kirk
authors.forename: Malcolm
authors.initials: M
authors.lastname: Donaldson
authors.forename: Sten-A
authors.initials: SA
authors.lastname: Ivarsson
authors.forename: Olle
authors.initials: O
authors.lastname: Söder
authors.forename: Edna
authors.initials: E
authors.lastname: Roche
authors.forename: Hilary
authors.initials: H
authors.lastname: Hoey
authors.forename: David B
authors.initials: DB
authors.lastname: Dunger
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
mesh_terms: D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006706:Homeostasis / Q000187:drug effects; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007236:Infant, Small for Gestational Age / Q000254:growth & development* / Q000378:metabolism; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008954:Models, Biological
chemical_list: D007328:Insulin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I