Efficacy and safety of long-term continuous growth hormone treatment of children born small for gestational age

被引:26
作者
Hokken-Koelega, A [1 ]
van Pareren, Y [1 ]
Arends, N [1 ]
Boonstra, V [1 ]
机构
[1] Erasmus Univ, Med Ctr, Sophia Childrens Hosp, Dept Paediat,Div Endocrinol, NL-3000 CB Rotterdam, Netherlands
关键词
small for gestational age; growth hormone; adult height; adrenarche; puberty; glucose metabolism;
D O I
10.1159/000080518
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Twelve years of growth hormone (GH) therapy of short children born small for gestational age (SGA) have demonstrated that GH is an effective and well-tolerated therapy. Most children will reach a normal adult height (AH). AH of 55 SGA adolescents was comparable for those treated with a GH dose of 1 or 2 mg/m(2) (similar to0.033 or 0.066 mg/kg) per day, mean (SD) AH SDS being -1.2 (0.7) and -0.8 (0.7), respectively. GH therapy had no influence on the age at onset, the progression of puberty, duration of puberty and pubertal height gain. GH therapy induced higher fasting and glucose-stimulated insulin levels after 1 and 6 years, but 6 months after GH stop, all levels returned to normal. At baseline mean systolic blood pressure was significantly increased, but both systolic and diastolic blood pressure decreased significantly during 6 years of GH and remained so after GH stop. GH therapy demonstrated a beneficial effect on serum lipid profiles, body composition, bone mineral density and head growth. Treatment with 2 mg GH/m(2) per day induced mean serum IGF-I levels of +2 SDS, whereas IGF-I levels remained within the normal range with 1 mg GH/m(2) per day. In conclusion, long-term GH therapy of short SGA children with 1 mg/m(2) per day appears to be effective and safe. Since the future consequences of high serum IGF-I levels during long-term GH therapy with 2 mg/m(2) per day are as yet unknown, it seems safer to treat short prepubertal SGA children with a GH dose of 1 mg/m(2) per day when children are to be treated continuously for many years. Copyright (C) 2004 S. Karger AG, Basel.
引用
收藏
页码:149 / 154
页数:6
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