Body composition, blood pressure, and lipid metabolism before and during long-term growth hormone (CH) treatment in children with short stature born small for gestational age either with or without GH deficiency

To assess the effects of long-term continuous GH treatment on body composition, blood pressure (BP), and lipid metabolism in children with short stature born small for gestational age (SGA), body mass index (BMI), skinfold thickness measurements, systemic BP measurements, and levels of blood lipids were evaluated in 79 children with a baseline age of 3-11 vr with short stature (height SD-score, < -1.88) born SGA (birth length so-score, < -1.88). Twenty-two of the 79 children were GH deficient (GHD). All children participated in a randomized, double-blind, dose-response multicenter GH trial. Four; and 6-yr data were compared between two GH dosage groups (3 us. 6 IU/m(2) body surface/day). Untreated children with short stature born SGA are lean (mean BMI so-score, -1.3; mean so-score skinfolds, -0.8), have a higher systolic BP (SD-score, 0.7) but normal diastolic BP (SD-score, -0.1), and normal lipids (total cholesterol, 4.7 mmol/L; low-density lipoprotein, 2.9 mmol/L; high-density lipoprotein, 1.3 mmol/L) compared with healthy peers. During long-term continuous GH treatment, the BMI normalized without overall changes in sc fat. compared with age-matched references, whereas the BP so-score and the atherogenic index decreased significantly. Although the mean 6-yr increase in height so-score was significantly higher in the children receiving GN treatment with 6 IU/m(2).day (2.7) than in those receiving treatment with 3 IU/m(2).day (2.2), no differences in the changes in BMI, skinfold measurements, BP, and lipids were found between the GH dosage groups. The pretreatment so-scores for BMI, skinfold, and BP, as well as the lipid levels, were not significantly different between GHD and non-GHD children, but after 6 yr of GH treatment the skinfold so-score and BP so-score had decreased significantly more in the GHD than in the non-GHD children. Our data indicate that GH treatment has at least up to 6 yr positive instead of negative effects on body composition, BP, and lipid metabolism. In view of the reported higher risk of cardiovascular diseases in later life in children born SCA, further research into adulthood remains warranted.