[Effects of growth hormone treatment on anthropometrics, metabolic risk, and body composition variables in small for gestational age patients].
OBJECTIVE
Small for gestational age (SGA) children without catch-up growth can benefit from treatment with growth hormone (rhGH). However, they should be monitored very closely because they are at increased risk of metabolic syndrome.


METHODS
A group of 28 SGA children with a mean age of 8.79 years and undergoing treatment with rhGH were selected for evaluation. Over the course of 4 years, an annual evaluation was performed on the anthropometric variables (weight, height, body mass index [BMI], growth rate, blood pressure and waist perimeter), metabolic risk variables (glycaemia, glycosylated haemoglobin, cholesterol ratio, insulinaemia, insulin-like growth factor 1[IGF1], IGF binding protein-3 [IGFBP-3], IGF1/IGFBP3 ratio, and HOMA index), and body composition variables.


RESULTS
Treatment with rhGH was associated with a significant increase in height (-2.76±.11 SD to -1.53±.17 SD, P=.000), weight (-1.50±.09 SD to -1.21±.13 SD; P=.016), and growth rate (-1.43±.35 SD to .41±.41 SD; P=.009), without a corresponding change in the BMI. Insulinaemia (9.33±1.93mU/ml to 16.55±1.72mU/ml; P=.044) and the HOMA index (3.63±.76 to 6.43±.67; P=.042) increased, approaching insulin resistance levels. No changes were observed in the lipid profile. Body composition changes were observed, with a significant increase in lean mass (73.19±1.26 to 78.74±1.31; P=.037), and a reduction of fat mass (26.81±1.26 to 21.26±1.31; P=.021).


CONCLUSIONS
Treatment with rhGH is effective for improving anthropometric variables in SGA patients who have not experienced a catch-up growth. It also produces changes in body composition, which may lead to a reduction in risk of metabolic syndrome. However, some insulin resistance was observed. It is important to follow up this patient group in order to find out whether these changes persist into adulthood.
Departamento de Pediatría, Hospital de Barbastro, Barbastro, Huesca, España. Electronic address: estheraurensanz@gmail.com.
Esther
E
Aurensanz Clemente
Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
Pilar
P
Samper Villagrasa
Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España; Departamento de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, España.
Ariadna
A
Ayerza Casas
Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, España.
Pablo
P
Ruiz Frontera
Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
Olga
O
Bueno Lozano
Growth Exercise Nutrition and Development (GENUD) Research Group, España; Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España.
Luis Alberto
LA
Moreno Aznar
Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
Gloria
G
Bueno Lozano
D000293:Adolescent; D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008137:Longitudinal Studies; D008297:Male; D008659:Metabolic Diseases / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors
D019382:Human Growth Hormone
Body composition; Cardiovascular risk; Composición corporal; Growth hormone; Hormona de crecimiento; Insulin resistance; Lipoproteins; Lipoproteínas; Pequeño para edad gestacional; Resistencia a la insulina; Riesgo cardiovascular; Small for gestational age