Introduction: Growth depends on growth hormone (GH) secretion and on individual sensitivity to its action. The effects of birth parameters on growth and metabolic status are well documented in small-for-gestational-age children, but in children with GH deficiency those associations are not clear. Taking into account that GH-deficient children are not a homogenic group of patients, the importance of an individual approach to GH doses and the assessment of the effects of GH therapy is emphasised.
Aim of the study: We investigated the associations between birth weight (BW) and length (BL) and gestational age (GA) and anthropometric and biochemical parameters in GH- deficient children before and in the first year of GH therapy.
Material and Methods: We analysed the data of 45 GH-deficient children (34 prepubertal, 11 pubertal) with mean BW –0.5±1.02 SD and mean BL –0.6±1.19. BW and BL were expressed as SDS for sex and GA. Height was expressed as SDS for chronological age, weight and BMI were expressed as SDS for height-age. Adiponectin, resistin, fasting glucose, fasting insulin, HOMA-IR, QUICKI, HbA1c, lipid profile, IGF-1 were analysed at baseline and during GH therapy.
Results: We found that BW correlated with baseline height SDS in prepubertal patients (R=0.38, P=0.029) and with height SDS after 12 months of GH therapy (R=0.73, P=0.016) in pubertal patients. GA was associated with both weight SDS and BMI SDS at baseline and after 6 and 12 months of GH therapy in prepubertal patients. Further analysis revealed that in prepubertal children GA was associated with adiponectin (R=0.39, P=0.029) and fasting glucose (R=–0.45, P=0.008) at baseline and with resistin (R=–0.49, P=0.015), IGF-1 SDS (R=0.44, P=0.009) and with increase in IGF-1 SDS (R=0.47, P=0.018) after the first 6 months of GH therapy. In pubertal patients we only found that baseline resistin was adversely associated with GA and BL (R=–0.64, P=0.035; R=–0.65, P=0.031, respectively). No correlations with insulin, HOMA-IR, QUICKI and lipid profile were found.
Conclusions: BW and GA seemed to be important factors affecting height deficit and nutritional status in GH-deficient children, especially before puberty. Higher GA is associated with better IGF-1 response to GH therapy, lower resistin and glucose levels at baseline and during GH therapy.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology