ESPE Abstracts

Background: Children who were born small for gestational age (SGA) or with intrauterine growth restriction (IUGR) have increased risk of metabolic disorders such as insulin resistance, diabetes mellitus type 2 and coronary disease in adultness. Most of those children after catch-up growth achieve the same growth as their peers. Nevertheless 10 % of them persist finally short as adults. In the last decade some countries introduced the rhGH treatment to improve the final height in this children. The interest is whether the rhGH treatment gives this patient additional metabolic advantages.

Aim of study: The aim of study was to analyze carbohydrate metabolism parameters in SGA children before and in the course of rhGH treatment.

Material and Methods: We analyzed medical records of 86 pediatric patients, which 41 were SGA children with normal GH secretion and 45 children with growth hormone deficiency (GHD).

We used the data taken before the treatment with rhGH from both groups and we compared them with each other. We used following parameters: fasting glucose, fasting insulin, HbA1c levels and HOMA-IR, QUICKI indexes.

In SGA group we used data before and after one year of treatment with rhGH. We compare the same parameters as before the treatment and additionally glucose and insulin levels after 2 hours of oral glucose tolerance test.

Results: In our study there were no significant differences in fasting glucose, fasting insulin, HbA1c value and HOMA-IR, QUICKI indexes between both groups before growth hormone treatment.

After 1 year of treatment in the SGA/IUGR patients there was statistically significant difference in insulin level in 120 min OGTT (P=0,03).

No significant difference was found in fasting glucose, glucose in 120 min of OGTT, fasting insulin, insulin in 120 min of OGTT, HOMA-IR, QUICKI. One patient fulfilled the criteria of impaired glucose tolerance (IGT).

Conclusions: Statistically significant higher concentration of insulin in OGTT in SGA children during rhGH treatment may suggest that in these patients, growth promoting therapy does not provide parallel metabolic benefits.

Keywords: Fasting insulin, fasting glycemia, insulin resistance, HOMA-IR, QUICKI, SGA