HIGH-DOSE GROWTH-HORMONE TREATMENT OF SHORT CHILDREN BORN SMALL-FOR-GESTATIONAL-AGE

The effect of GH administration was evaluated over 2 yr in 50 short, p repubertal, non-GH deficient children born small for gestational age, who had been randomly allocated to a group receiving no treatment or d aily sc GH treatment at a dose of 0.2 or 0.3 IU/kg. At the start of th e study, mean age was 5.2 yr, bone age was 4.0 yr, height sos was -3.5 , height velocity sos was -0.8, weight SDS was -2.7, and body mass ind ex SDS was -1.9. Catch-up growth was observed in none of the untreated and all of the treated children. The response to GH treatment include d a near doubling of growth velocity and of weight gain and a mean hei ght increment of more than 2 SDS. GH treatment was associated with a d istinct acceleration of bone maturation. The differences between the g rowth responses evoked by the two GH doses were minor. The prepubertal GH-induced catch-up growth was associated with elevated serum concent rations of insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-3, and osteocalcin, whereas insulin-like growth factor-II levels remained unaltered. GH treatment was well tolerated. In conclusion, high-dose GH administration over 2 yr is emerging as a potential therapy to increase the short stature that results from ins ufficient catch-up growth in young children born small for gestational age. The long-term impact of this approach remains to be delineated.