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Insulin sensitivity decreases in short children born small for gestational age treated with growth hormone

Sara Bachmann1, Susanne Bechtold, Walter Bonfig

  • 1Division of Endocrinology and Diabetology, University Children's Hospital, Munich, Germany.

The Journal of Pediatrics
|November 29, 2008
PubMed

Insights

Growth hormone treatment in short children born small for gestational age (SGA) can impair insulin sensitivity. This decrease is more pronounced in children nearing puberty or with lower body mass index, indicating an increased risk for insulin resistance.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Research

Background:

  • Children born small for gestational age (SGA) often exhibit short stature.
  • Insulin sensitivity is a critical metabolic parameter influencing long-term health.
  • Growth hormone (GH) therapy is a common treatment for short stature in SGA children.

Purpose of the Study:

  • To assess insulin sensitivity in short children born SGA before and after GH treatment.
  • To investigate the correlation between growth response and insulin levels in these children.

Main Methods:

  • A cohort of 29 short SGA children underwent oral glucose tolerance tests.
  • Insulin sensitivity was evaluated using homeostasis model assessment (HOMA) and Matsuda's insulin sensitivity index (ISI).
  • Measurements were taken before and after one year of GH treatment (33 microg/kg/day).

Main Results:

  • GH treatment led to a significant increase in height (from -3.1 to -2.4 SD).
  • Insulin sensitivity significantly decreased post-treatment (ISI from 12.2 to 6.1; HOMA from 1.2 to 2.2).
  • Insulin resistance (ISI<5) prevalence rose from 17.2% to 48.3%, particularly in pubertal children. ISI correlated negatively with age and BMI, but not height gain.

Conclusions:

  • Insulin sensitivity is compromised in some SGA children at baseline and further reduced by GH therapy.
  • Children approaching puberty and those with lower body weight are at higher risk of developing insulin resistance.
  • Monitoring insulin sensitivity is crucial during GH treatment for short SGA children.
Abstract

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