Background: GH treatment results in a decrease in fat mass (FM) and insulin sensitivity (Si), and an increase in lean body mass (LBM). Only limited data are available on the longitudinal changes after discontinuation of GH treatment in SGA adults, aged 21 years.
Objective and hypotheses: To assess longitudinal changes in body composition (BC) and glucose homeostasis after stop of GH treatment in SGA adults.
Method: 197 previously GH-treated SGA adults were longitudinally followed after stop of GH treatment; at adult height, and 6 months, 2 yrs and 5 yrs thereafter. Data at 5 yrs after GH were compared to untreated adults born SGA with short stature (SGA-S) or spontaneous catch-up growth (SGA-CU), and adults born AGA. BC was determined by DXA scans and Si, acute insulin response (AIR) and β-cell function (DI) were assessed by frequently sampled intravenous glucose tolerance tests.
Results: FM, trunk fat and limb fat increased steadily from stop of GH until 6 months, 2 yrs and 5 yrs thereafter (P<0.001). During 6 months after GH, LBM decreased (P<0.001), Si increased (P<0.001), AIR decreased (P<0.001) and DI increased (P=0.032) but all remained unchanged thereafter. At the age of 21 years, 5yrs after stop of GH, FM, Si and AIR were similar, LBM lower and DI higher in previously GH-treated SGA adults compared to age-matched SGA-S, SGA-CU and AGA adults.
Conclusion: After GH treatment, body composition and glucose homeostasis changed, reflecting the loss of GH properties. FM steadily increased until 5 yrs after GH. GH-induced changes in Si and DI were fully reversed within 6 months after GH and remained similar during 5 yrs. At the age of 21 yrs, 5 yrs after GH, body composition and glucose homeostasis of previously GH-treated SGA adults were comparable to SGA-S, SGA-CU and AGA adults. Since the increase in FM is potentially unfavourable when persisting over time, further longitudinal evaluation of metabolic parameters is warranted.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology