ESPE2024 Poster Category 1 GH and IGFs 1 (11 abstracts)
Department of Pediatrics, Hamad General Hospital, Doha, Qatar
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.