ESPE Abstracts

Children born small for gestational age (SGA) not showing catch-up growth in the first two years of life may show decreased growth rate and adult height, as well as worse metabolic profile, compared to general population. In these patients, growth hormone (GH) treatment is recommended, showing positive effects on both growth rate and metabolic profile, with good tolerability. The aim of the current study was to evaluate the auxological and metabolic effects and the safety of GH treatment in SGA children. The study included 34 SGA children (15 F, 19 M; SGA for length and weight: 6 F, 9 M; SGA for length: 2 F, 1 M; SGA for weight: 6 F, 9 M; mean age: 8.72 ± 2.48 yrs; prepubertal: 19 M, 10 F; pubertal: 5 F) treated with GH (starting dosage: 32.24 ± 2.88 mcg/kg/die) for at least 24 months. Growth and metabolic parameters, including glycemic and lipid profile, transaminases, and urycemia, were collected every six months. Compared to baseline, SGA children showed a significant improvement in height, weight, and growth rate after two years of treatment with GH (p < 0.001), already evident after six months of treatment (p <0.001). Noteworthy, patients showed a constant, significant improvement in height throughout the treatment, as a significantly increase was observed both after one year of treatment compared to baseline (p < 0.001) and after two years of treatment compared to first year of treatment (P= 0.03). Conversely, although significantly higher than baseline at each visit (p < 0.001), after the six-months peak growth rate significantly decreased over time until 18 months of treatments (p < 0.001 T6 vs T12; P= 0.015 T12 vs T18), remaining thereby stable. Considering metabolic parameters, compared to baseline, a recurring increase in glycemia (p ≤ 0.042 vs T12 and T18) and urycemia (p ≤ 0.01 vs T12, T18, and T24) and decrease in AST (p ≤ 0.021 vs T12, T18, and T24) and an occasional decrease in LDL cholesterol (P= 0.03 vs T24) were observed. Considering safety profile, treatment was well tolerated, as the most frequently reported adverse event was poor compliance (11.8%); no hyperglycemia or hyperstransaminasemia occurred throughout the treatment, whereas one patient (2.9%) experience hypercholesterolemia. In conclusion, GH treatment in SGA children is an effective, safe treatment for short stature, improving both height and growth rate, especially during the first year of treatment, although the metabolic profile of treated patients should be carefully monitored during time.