Growth and Metabolic Data Following Growth Hormone Treatment of Children with Intrauterine Growth Retardation

Abstract

Twenty-five short children (6F, 19M) with intrauterine growth retardation were treated with daily subcutaneous injections of biosynthetic human growth hormone for 4 years. The treatment was commenced at a chronological age of 6.3 years (range 2.1-9.8). Eighteen of the patients had major dysmorphic signs of Russell-Silver syndrome. During the first year they were randomised into two groups treated with either 15 or 30 IU of growth hormone/m²/week. The higher dose was administered to all the children after the first year of the trial. After the initial increase in growth velocity SDS (greater in those treated with the higher dose regimen), there was a progressive decrease although with values significantly higher than pretreatment levels (p < 0.02) in both groups. However there was no improvement in height SDS for bone age after 4 years. The triceps and skinfold thickness showed a decrease during the first years followed by a gradual increase. The body mass index improved during the 4 years although showing no difference between the two treatment groups. There was no alteration in thyroid function or metabolic indices (glucose or lipid homeostasis) during the study.

Growth Hormone in the Treatment of Short Stature in Young Children with Intrauterine Growth Retardation

“…In the 1980s, most reports in the literature were discouraging due possibly to insufficient supplies of GH. Two recent studies, however, have shown an important catch-up growth with a mean gain in height standard deviation of 1.60 in IUGR short children following 3 years of treatment with dosages of GH approximately three times the usual replacement dose [15, 16]. …”

Growth Hormone Treatment in Children with Short Stature Born Small for Gestational Age: 5-Year Results of a Randomized, Double-Blind, Dose-Response Trial

“…Initial data were disappointing, probably due to the low dose and frequency of GH administration. Recent short term studies have shown that daily administration of recombinant human GH therapy in varying dosages accelerates growth significantly in short children born SGA (7,(15)(16)(17)(18)(19)(20)(21)(22).…”

Body Composition, Blood Pressure, and Lipid Metabolism before and during Long-Term Growth Hormone (GH) Treatment in Children with Short Stature Born Small for Gestational Age Either with or without GH Deficiency1

“…It has been previously shown that disturbances in the GH/insulin-like growth factor I axis may account for some of the growth retardation: up to 60% of the short children born SGA have GH-secretory abnormalities and/or reduced levels of insulin-like growth factors (6 -12). Studies have shown that continuous or discontinuous treatment with recombinant human GH in varying dosages accelerates growth significantly in short children born SGA, resulting in catch-up growth to values within the normal range, followed by growth along their target height percentile (7,(13)(14)(15)(16)(17)(18)(19)(20)(21).SGA has been associated with increased prevalence of diabetes mellitus type II, hypertension, and hyperlipidemia at a relative young age in later life (22). All three disorders are risk factors of cardiovascular diseases.…”