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Submitted on May 17, 2006
Accepted on October 16, 2006
Department of Pediatrics, Division of Endocrinology, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands, Department of Epidemiology & Biostatistics, Erasmus MC, Rotterdam, The Netherlands
* To whom correspondence should be addressed. E-mail: m.vandijk.1{at}erasmusmc.nl.
Context. Low birth weight might increase risk of diabetes mellitus type 2 (DM-II) and metabolic syndrome (MS). Growth hormone (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 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) years. Mean duration of GH treatment had been 7.3 (1.3) years. Mean period after discontinuation was 6.5 (1.4) years. 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. BMI, waist circumference, HDL-c levels and triglycerids were equivalent. Systolic and diastolic blood pressure and cholesterol were significantly lower in GH-treated subjects. Thirty-two percent of untreated controls had an increased blood pressure vs. none of the GH-treated subjects. 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, BMI, waist circumference, 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 as they suggest that long-term GH-treatment does not increase the risk for DM-II and MS in young adults.
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