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      Effect of Different Growth Hormone Dosages on the Growth Velocity in Children Born Small for Gestational Age

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          To assess whether short-term growth hormone (GH) treatment can improve the linear growth in children who were born small for gestational age (SGA), we started a randomized multicenter trial in 26 age- and sex-matched prepubertal children born SGA. During the 1st year of GH therapy, all children received GH 0.23 mg/kg/week, then during the 2nd year, 13 children received the same dose (group A), and in the other 13 children, the dose of GH was doubled, i.e., 0.46 mg/kg/week (group B). During the 1st year of therapy, the growth velocity significantly (p < 0.0001) increased in all patients. During the 2nd year, group A showed a significant decrease of the growth velocity (p < 0.015), whereas group B maintained the growth rate. The height in group A children significantly increased during the 1st and the 2nd year of GH therapy (p < 0.000002 and p < 0.000001, respectively), reaching the normal range in 8 out of 13 children at the end of 2 years of GH therapy. The height in group B children significantly increased during the 1st and the 2nd year of GH therapy (p < 0.000001 and p < 0.000001, respectively), reaching the normal range in all 11 children who completed the GH therapy. The height gain was similar in groups A and B treated with the same GH dosage during the 1st year of therapy. A greater increase in height gain was found in children of group B treated with the higher GH dosage during the 2nd year of therapy as compared with group A (p < 0.02). Significant increases in insulin-like growth factor I (p < 0.0001), acid-labile subunit (p < 0.0002), and bone/chronological age ratio (p < 0.0001) were found after the 1st year of GH therapy, but no significant changes were observed during the 2nd year, independently of the GH dose. In conclusion, the height velocity of children born SGA significantly increases during the 1st year of GH therapy, diminishes, but can decrease during the 2nd year, if the GH dosage is not raised.

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          Most cited references 7

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          Insulin Resistance in Short Children with Intrauterine Growth Retardation

           P L Hofman (1997)
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            Growth Hormone Treatment in Children with Short Stature Born Small for Gestational Age: 5-Year Results of a Randomized, Double-Blind, Dose-Response Trial

             T. Sas (1999)
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              Plasma Levels of Insulin-Like Growth Factor (IGF)-I, IGF-II and IGF-Binding Protein-3 in the Evaluation of Childhood Growth Hormone Deficiency

              Background: Traditionally, measurement of plasma IGF-I and more recently of IGFBP-3 are used to distinguish GHD from idiopathic short stature in slowly growing children, using a single blood sample. In earlier studies it was claimed that IGFBP-3 was superior to IGF-I, but more recently doubts around this claim have arisen. The role of serum IGF-II has never been studied extensively. On theoretical grounds, it can also be hypothesized that molar ratios of these peptides might be of additional value. Design: Retrospective, multicentre, cohort study. Patients: 96 children evaluated for short stature. Methods: Serum IGF-I, IGF-II, IGFBP-3 and various molar ratios were, after correction for age and sex using SD scores, compared to the maximum serum GH peak after two standard provocation tests using four different methods (t-test, χ 2 , likelihood ratios and ROC curves). In addition, the correlations between these parameters and the short-term (1 year) and long-term (3 years) response to GH therapy were calculated. Results: IGF-I performed better than IGFBP-3, but the best results were achieved by the molar ratio IGF-I:IGF-II. However, IGFBP-3 correlated better with the short-term response to GH therapy than IGF-I or the ratios, and none of the parameters investigated was found to be related to the response of long-term GH therapy.

                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                March 2004
                02 March 2004
                : 61
                : 2
                : 98-102
                Departments of Pediatrics, Universities of aPavia, bVerona, cMessina, and dNovara, and eBiometrics Unit, IRCCS San Matteo, Pavia, Italy
                75340 Horm Res 2004;61:98–102
                © 2004 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 1, References: 26, Pages: 5
                Original Paper


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