This Article Full Text Full Text (PDF) All Versions of this Article: 92/1/160    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van Dijk, M. Articles by Hokken-Koelega, A. C. S. Search for Related Content PubMed PubMed Citation Articles by van Dijk, M. Articles by Hokken-Koelega, A. C. S. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Diabetes Metabolic Syndrome Hazardous Substances DB GLUCOSE Related Collections Pediatric Endocrinology Diabetes and Insulin Metabolism

Risk Factors for Diabetes Mellitus Type 2 and Metabolic Syndrome Are Comparable for Previously Growth Hormone-Treated Young Adults Born Small for Gestational Age (SGA) and Untreated Short SGA Controls

Department of Pediatrics (M.v.D., E.M.N.B., Y.K.v.P., A.C.S.H.-K.), Division of Endocrinology, Sophia Children’s Hospital, and Department of Epidemiology and Biostatistics (P.G.H.M.), Erasmus Medical Center, 3000 CB Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: Marije van Dijk, Erasmus Medical Center, Sophia Children’s Hospital, Department of Pediatrics, Division of Endocrinology, sb-2603, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands. E-mail: m.vandijk.1{at}erasmusmc.nl.

Context: Low birth weight might increase risk of diabetes mellitus type 2 and metabolic syndrome (MS). GH has insulin-antagonistic properties. Therefore, long-term follow-up of GH-treated children born small for gestational age (SGA) is important.

Objective and Patients: The objective of the study was to evaluate insulin sensitivity (Si) and disposition index (DI), all components of the MS and IGF-I and IGF binding protein (IGFBP)-3 levels in 37 previously GH-treated young SGA adults in comparison with 25 untreated short SGA controls.

Results: GH-treated subjects were 22.3 (1.7) yr old. Mean duration of GH treatment had been 7.3 (1.3) yr. Mean period after discontinuation was 6.5 (1.4) yr. Si and DI were comparable for GH-treated and untreated SGA subjects. Fasting glucose and insulin levels increased during GH treatment but recovered after discontinuation. Body mass index, waist circumference, high-density lipoprotein cholesterol levels, and triglycerides were equivalent. Systolic and diastolic blood pressure and cholesterol were significantly lower in GH-treated subjects. Thirty-two percent of untreated controls vs. none of the GH-treated subjects had an increased blood pressure. GH-induced rises in IGF-I and IGFBP-3 levels had completely recovered after GH stop.

Conclusion: At 6.5 yr after discontinuation of long-term GH treatment, Si, DI, fasting levels of glucose and insulin, body mass index, waist circumference, and IGF-I and IGFBP-3 levels were equivalent for GH-treated and untreated young SGA adults. Systolic and diastolic blood pressure and serum cholesterol were even lower in GH-treated subjects. These data are reassuring because they suggest that long-term GH treatment does not increase the risk for diabetes mellitus type 2 and MS in young adults.

This article has been cited by other articles:

				R. H. Willemsen, S. P. Willemsen, and A. C. S. Hokken-Koelega Longitudinal Changes in Insulin Sensitivity and Body Composition of Small-For-Gestational-Age Adolescents after Cessation of Growth Hormone Treatment J. Clin. Endocrinol. Metab., September 1, 2008; 93(9): 3449 - 3454. [Abstract] [Full Text] [PDF]

				L. Audi, A. Carrascosa, C. Esteban, M. Fernandez-Cancio, P. Andaluz, D. Yeste, R. Espadero, M. L. Granada, H. Wollmann, L. Fryklund, et al. The exon 3-deleted/full-length Growth Hormone Receptor Polymorphism Does Not Influence the Effect of Puberty or Growth Hormone Therapy on Glucose Homeostasis in Short Non-Growth Hormone-Deficient Small-for-Gestational-Age Children: Results from a Two-Year Controlled Prospective Study J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2709 - 2715. [Abstract] [Full Text] [PDF]

				J Rotteveel, M M van Weissenbruch, and H A Delemarre-Van de Waal Decreased insulin sensitivity in small for gestational age males treated with GH and preterm untreated males: a study in young adults. Eur. J. Endocrinol., June 1, 2008; 158(6): 899 - 904. [Abstract] [Full Text] [PDF]

				R. H. Willemsen, S. W. K. de Kort, D. C. M. van der Kaay, and A. C. S. Hokken-Koelega Independent Effects of Prematurity on Metabolic and Cardiovascular Risk Factors in Short Small-for-Gestational-Age Children J. Clin. Endocrinol. Metab., February 1, 2008; 93(2): 452 - 458. [Abstract] [Full Text] [PDF]

				J. Argente, R. Gracia, L. Ibanez, A. Oliver, E. Borrajo, A. Vela, J. P. Lopez-Siguero, M. L. Moreno, F. Rodriguez-Hierro, and on behalf of the Spanish SGA Working Group Improvement in Growth after Two Years of Growth Hormone Therapy in Very Young Children Born Small for Gestational Age and without Spontaneous Catch-Up Growth: Results of a Multicenter, Controlled, Randomized, Open Clinical Trial J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 3095 - 3101. [Abstract] [Full Text] [PDF]

				E M Delemarre, J Rotteveel, and H A D.-v. de Waal Metabolic implications of GH treatment in small for gestational age Eur. J. Endocrinol., August 1, 2007; 157(suppl_1): S47 - S50. [Abstract] [Full Text] [PDF]