TY - JOUR
T1 - Long-term effects of growth hormone (GH) treatment on body composition and bone mineral density in short children born small-for-gestational-age
T2 - six-year follow-up of a randomized controlled GH trial
AU - Willemsen, Ruben H
AU - Arends, Nicolette J T
AU - Bakker-van Waarde, Willie M
AU - Jansen, Maarten
AU - van Mil, Edgar G A H
AU - Mulder, Jaap
AU - Odink, Roelof J
AU - Reeser, Maarten
AU - Rongen-Westerlaken, Ciska
AU - Stokvis-Brantsma, Wilhelmina H
AU - Waelkens, Johan J J
AU - Hokken-Koelega, Anita C S
PY - 2007/10
Y1 - 2007/10
N2 - UNLABELLED: Context Alterations in the GH-IGF-I axis in short small-for-gestational-age (SGA) children might be associated with abnormalities in bone mineral density (BMD) and body composition. In addition, birth weight has been inversely associated with diabetes and cardiovascular disease in adult life. Data on detailed body composition in short SGA children and long-term effects of GH treatment are very scarce.OBJECTIVE: To investigate effects of long-term GH treatment on body composition and BMD by dual energy X-ray absorptiometry (DXA) in short SGA children.DESIGN: Longitudinal 6-year GH study with a randomized controlled part for 3 years.RESULTS: At baseline, fat percentage standard deviation score (SDS) and lumbar spine BMD SDS corrected for height (BMAD(LS) SDS) were significantly lower than zero. Lean body mass (LBM) SDS adjusted for age was also reduced, but LBM adjusted for height (LBM SDS(height)) was not decreased. GH treatment induced a decrease in fat percentage SDS and an increase in BMAD(LS) SDS. LBM SDS(height) remained similar in GH-treated children, but deteriorated in untreated controls. When these untreated controls subsequently started GH treatment, their LBM SDS(height) rapidly normalized to values comparable with zero.CONCLUSION: During long-term GH treatment in short SGA children, fat percentage SDS decreased and BMAD(LS) SDS increased. These effects of GH treatment were most prominent in children who started treatment at a younger age and in those with greater height gain during GH treatment. LBM SDS(height )remained around 0 SDS in GH-treated children, but declined to low normal values in untreated controls.
AB - UNLABELLED: Context Alterations in the GH-IGF-I axis in short small-for-gestational-age (SGA) children might be associated with abnormalities in bone mineral density (BMD) and body composition. In addition, birth weight has been inversely associated with diabetes and cardiovascular disease in adult life. Data on detailed body composition in short SGA children and long-term effects of GH treatment are very scarce.OBJECTIVE: To investigate effects of long-term GH treatment on body composition and BMD by dual energy X-ray absorptiometry (DXA) in short SGA children.DESIGN: Longitudinal 6-year GH study with a randomized controlled part for 3 years.RESULTS: At baseline, fat percentage standard deviation score (SDS) and lumbar spine BMD SDS corrected for height (BMAD(LS) SDS) were significantly lower than zero. Lean body mass (LBM) SDS adjusted for age was also reduced, but LBM adjusted for height (LBM SDS(height)) was not decreased. GH treatment induced a decrease in fat percentage SDS and an increase in BMAD(LS) SDS. LBM SDS(height) remained similar in GH-treated children, but deteriorated in untreated controls. When these untreated controls subsequently started GH treatment, their LBM SDS(height) rapidly normalized to values comparable with zero.CONCLUSION: During long-term GH treatment in short SGA children, fat percentage SDS decreased and BMAD(LS) SDS increased. These effects of GH treatment were most prominent in children who started treatment at a younger age and in those with greater height gain during GH treatment. LBM SDS(height )remained around 0 SDS in GH-treated children, but declined to low normal values in untreated controls.
KW - Absorptiometry, Photon
KW - Body Composition/drug effects
KW - Body Height/drug effects
KW - Bone Density/drug effects
KW - Child
KW - Female
KW - Follow-Up Studies
KW - Human Growth Hormone/therapeutic use
KW - Humans
KW - Infant, Newborn
KW - Infant, Small for Gestational Age
KW - Insulin-Like Growth Factor Binding Protein 3/blood
KW - Insulin-Like Growth Factor I/analysis
KW - Lumbar Vertebrae
KW - Male
KW - Time
U2 - 10.1111/j.1365-2265.2007.02913.x
DO - 10.1111/j.1365-2265.2007.02913.x
M3 - Article
C2 - 17561977
SN - 0300-0664
VL - 67
SP - 485
EP - 492
JO - Clinical Endocrinology
JF - Clinical Endocrinology
IS - 4
ER -