Journal of Clinical Endocrinology & Metabolism, Vol 81, 1887-1892, Copyright © 1996 by Endocrine Society

ARTICLES

High-dose growth hormone treatment of short children born small for gestational age

F de Zegher, M Maes, SE Gargosky, C Heinrichs, MV Du Caju, G Thiry, J De Schepper, M Craen, L Breysem, A Lofstrom, P Jonsson, JP Bourguignon, P Malvaux and RG Rosenfeld
Belgian Study Group for Pediatric Endocrinology, Department of Pediatrics, University of Leuven, Belgium.

The effect of GH administration was evaluated over 2 yr in 50 short, prepubertal, non-GH deficient children born small for gestational age, who had been randomly allocated to a group receiving no treatment or daily sc GH treatment at a dose of 0.2 or 0.3 IU/kg. At the start of the study, mean age was 5.2 yr, bone age was 4.0 yr, height SDS was - 3.5, height velocity SDS was -0.8, weight SDS was -2.7, and body mass index SDS was -1.9. Catch-up growth was observed in none of the untreated and all of the treated children. The response to GH treatment included a near doubling of growth velocity and of weight gain and a mean height increment of more than 2 SDS. GH treatment was associated with a distinct acceleration of bone maturation. The differences between the growth responses evoked by the two GH doses were minor. The prepubertal GH-induced catch-up growth was associated with elevated serum concentrations of insulin, insulin-like growth factor-I, insulin- like growth factor binding protein-3, and osteocalcin, whereas insulin- like growth factor-II levels remained unaltered. GH treatment was well tolerated. In conclusion, high-dose GH administration over 2 yr is emerging as a potential therapy to increase the short stature that results from insufficient catch-up growth in young children born small for gestational age. The long-term impact of this approach remains to be delineated.

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