ESPE Abstracts (2015) 84 P-3-939

Increasing Lean Body Mass, Phase Angle, and Total Body Water But Decreasing Body Fat Among Short-statured Children Born Small-for-Gestational Age on GH Treatment

Thomas M K Völkl, Isabel Stumpf & Helmuth-G Dörr


Division of Paediatric Endocrinology and Diabetology, Department of Paediatrics and Adolescent Medicine, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany


Background: There is a small proportion of children born SGA without postnatal catch-up growth who are presented with persistent short stature, low BMI, and decreased lean body mass (LBM). Data on body composition are rarely reported in the literature. Our study addresses the question whether human recombinant GH treatment could affect body composition in these SGA children or not.

Design: We included 58 SGA children (n=20 females) with SGA (birth weight and/or birth length <−2.0 SDS). At start of GH treatment, chronol. ages varied between 3.5 and 12 years (median 9 years). GH was administered daily s.c. in a mean GH dose of 35 μg/kg BW). Body composition was measured by single-frequency bioelectrical impedance analysis (BIA) at start of GH, and thereafter annually for 4 years. LBM, phase angle (PA), total body water (TBW), and body fat (BF) values were converted into SDS. Additionally, IGF1 and IGFBP3 levels were obtained.

Results: (median (IQR: 25th; 75th percentile): Height SDS and BMI SDS significantly increased (H: start −3.4 (−3.6, −3.0); 1st year −2.4 (−2.5, −2.0); 4th year −1.1 (−1.8, −0.7); BMI: start −1.1 (−1.4, −0.5); 1st year −0.8 (−1.3, −0.3); 4th year −0.4 (−1.1, −0.7)). Serum IGF1 SDS and IGFBP3 SDS increased after start of GH (IGF1: start −1.3 (−1.9, −0.4); 1st year 1.2 (−0.1, 2.4); 4th year 1.5 (0.3, 2.5); IGFBP3: start −0.2 (−0.9, 0.4); 1st year 1.5 (0.6, 2.3); 4th year 1.3 (0.2, 1.9)). Parameters derived from BIA showed decreasing body fat SDS (start −0.7 (−1.4, 0.2); 1st year −1.7 (−2.5, −0.9); 4th year −1.6 (−2.1, −0.9)), increasing LBM (start −1.9 (−2.4, −1.4); 1st year −0.76 (−1.3, −0.2); 4th year −0.2 (−0.7, 0.6)), increasing TBW (start −1.8 (−2.1, −1.6); 1st year −0.9 (−1.3, −0.7); 4th year −0.6 (−1.0, 0.5)), and – as a measure for sufficient cell metabolism – an increasing phase angle (start −0.3 (−1.0, 0.5); 1st year 0.2 (−0.4, 0.8); 4th year 0.8 (0.3, 1.5)).

Conclusions: In SGA children on GH treatment, our data show a significant improvement of body composition in terms of body fat, lean mass and general cellular integrity.

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