The Metabolic Impacts of GH Therapy in SGA Children and Its Effects on Various Metabolic Parameters and Health Outcomes

Fawzia Alyafei; Ashraf Soliman; Nada Alaaraj; Noor Hamed; Shayma Ahmed; Sohair Elsiddig

Introduction: Children born small for gestational age (SGA) are susceptible to abnormal glucose metabolism and insulin resistance, which may be exacerbated by (GH) therapy.

Methods: A comprehensive analysis of existing literature was conducted to assess the outcomes and implications of GH treatment in this specific pediatric population.

Results: 10 studies were reviewed, (1458 SGA children).


Study Authors	Year	Main Findings	Number of Children	Effects on Liver and Cardiovascular System
Sas et al.	2000	GH treatment had positive effects on body composition, BP, and lipid metabolism.	79	Beneficial impacts on cardiovascular risk factors
Sas et al.	2001	Continuous GH treatment showed no adverse effects on glucose levels but induced higher insulin levels,	78	No adverse effects on glucose levels; increased insulin levels indicating relative insulin resistance
Hokken-Koelega et al.	2003	Long-term GH therapy induced higher insulin levels, indicating insulin resistance.	165	Positive effect on blood pressure; insulin levels indicating insulin resistance but returned to normal post-therapy
van Pareren et al.	2003	Discontinuation of GH therapy did not affect glucose levels but normalized fasting insulin levels; lipid profiles remained stable.	47	Positive cardiovascular profile maintained post-GH therapy
Delemarre et al.	2007	Reviewed data on GH/IGF-I axis involvement in metabolism, suggesting potential long-term metabolic implications.	Review article	Highlighted possible implications for glucose/insulin metabolism and cardiovascular health
Breukhoven et al.	2011	Long-term GH treatment had no unfavorable effects on body composition or fat distribution in adulthood.	377 (59 GH-treated)	Neutral cardiovascular impact
van der Steen et al.	2017	Five years post-GH cessation, showed no unfavorable impacts on metabolic health.	199	Fat mass, insulin sensitivity, and β-cell function similar to untreated SGA adults
Dunger et al.	2019	Limited evidence suggested GH therapy's beneficial effect on metabolic and cardiovascular risks in SGA children.	Review article	Potential benefits for cardiovascular health
Goedegebuure et al.	2020	Follow-up shows that GnRHa/GH treatment has no unfavorable effects on metabolic and bone health	363	Similar metabolic health and bone density to GH-only and AGA control groups
Goedegebuure et al.	2022	Longitudinal study shows SGA-GH treated adults maintained normal metabolic and cardiovascular health profiles 12 years post-GH treatment.	167	Similar metabolic and cardiovascular health profiles to untreated adults born SGA or appropriate for gestational age

Conclusion: GH therapy in children born SGA is associated with improved growth and body composition, alongside potential cardiovascular benefits. However, it may influence glucose metabolism and insulin sensitivity, underscoring the importance of careful monitoring.

ESPE Abstracts

P1-51