title: Eight years of growth hormone treatment in children with Prader-Willi syndrome: maintaining the positive effects.
abstract: BACKGROUND
  The most important reason for treating children with Prader-Willi syndrome (PWS) with GH is to optimize their body composition.
  
  
  OBJECTIVE
  The aim of this ongoing study was to determine whether long-term GH treatment can counteract the clinical course of increasing obesity in PWS by maintaining the improved body composition brought during early treatment.
  
  
  METHODS
  This was a multicenter prospective cohort study.
  
  
  METHODS
  We have been following 60 prepubertal children for 8 years of continuous GH treatment (1 mg/m(2)/d ≈ 0.035 mg/kg/d) and used the same dual-energy x-ray absorptiometry machine for annual measurements of lean body mass and percent fat.
  
  
  RESULTS
  After a significant increase during the first year of GH treatment (P < .0001), lean body mass remained stable for 7 years at a level above baseline (P < .0001). After a significant decrease in the first year, percent fat SD score (SDS) and body mass index SDS remained stable at a level not significantly higher than at baseline (P = .06, P = .14, resp.). However, body mass index SDSPWS was significantly lower after 8 years of GH treatment than at baseline (P < .0001). After 8 years of treatment, height SDS and head circumference SDS had completely normalized. IGF-1 SDS increased to +2.36 SDS during the first year of treatment (P < .0001) and remained stable since then. GH treatment did not adversely affect glucose homeostasis, serum lipids, blood pressure, and bone maturation.
  
  
  CONCLUSIONS
  This 8-year study demonstrates that GH treatment is a potent force for counteracting the clinical course of obesity in children with PWS.
authors.affiliation: Westzeedijk 106, 3016 AH Rotterdam, The Netherlands. n.bakker@kindengroei.nl.
authors.forename: N E
authors.initials: NE
authors.lastname: Bakker
authors.forename: R J
authors.initials: RJ
authors.lastname: Kuppens
authors.forename: E P C
authors.initials: EP
authors.lastname: Siemensma
authors.forename: R F A
authors.initials: RF
authors.lastname: Tummers-de Lind van Wijngaarden
authors.forename: D A M
authors.initials: DA
authors.lastname: Festen
authors.forename: G C B
authors.initials: GC
authors.lastname: Bindels-de Heus
authors.forename: G
authors.initials: G
authors.lastname: Bocca
authors.forename: D A J P
authors.initials: DA
authors.lastname: Haring
authors.forename: J J G
authors.initials: JJ
authors.lastname: Hoorweg-Nijman
authors.forename: E C A M
authors.initials: EC
authors.lastname: Houdijk
authors.forename: P E
authors.initials: PE
authors.lastname: Jira
authors.forename: L
authors.initials: L
authors.lastname: Lunshof
authors.forename: R J
authors.initials: RJ
authors.lastname: Odink
authors.forename: W
authors.initials: W
authors.lastname: Oostdijk
authors.forename: J
authors.initials: J
authors.lastname: Rotteveel
authors.forename: E J
authors.initials: EJ
authors.lastname: Schroor
authors.forename: A A E M
authors.initials: AA
authors.lastname: Van Alfen
authors.forename: M
authors.initials: M
authors.lastname: Van Leeuwen
authors.forename: E
authors.initials: E
authors.lastname: Van Pinxteren-Nagler
authors.forename: H
authors.initials: H
authors.lastname: Van Wieringen
authors.forename: R C F M
authors.initials: RC
authors.lastname: Vreuls
authors.forename: N
authors.initials: N
authors.lastname: Zwaveling-Soonawala
authors.forename: M A J
authors.initials: MA
authors.lastname: de Ridder
authors.forename: A C S
authors.initials: AC
authors.lastname: Hokken-Koelega
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D019382:Human Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009765:Obesity / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011218:Prader-Willi Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone