Metabolic consequences of growth hormone treatment in paediatric practice

No metabolic side-effects of clinical significance have been reported durin g a 5-year study of growth hormone (GH) therapy in children with GH deficie ncy, Turner syn drome, idiopathic short stature or chronic renal insufficie ncy. In particular, insulin levels increase but remain within the normal ra nge, as do glucose and haemoglobin A(1c). A recent study showed that the ef fects of growth on insulin sensitivity in prepubertal children with idiopat hic short stature represent the changes in carbohydrate tolerance observed during normal adolescence. Thus, GH treatment may lead to prolongation of t he physiological state of insulin resistance observed in normal puberty. In sulin levels during the fasting state and 2 h after a standard glucose load showed no further rise after the first 3 years of continuous GH therapy. T he hyperinsulinaemia observed during GH therapy may, therefore, amplify the anabolic effects of insulin on protein metabolism during puberty. Copyrigh t (C) 2000 S. Karger AG, Basel.