Body proportions during 6 years of GH treatment in children with short stature born small for gestational age participating in a randomised, double-blind, dose-response trial

OBJECTIVE The aim of this study was to assess body proportions in children with short stature born small for gestational age (SGA) before and during 6 years of growth hormone (GH) treatment. DESIGN A prospective randomised double-blind dose-response study comparing the effects of 3 vs. 6 IU GH/m(2)/day. PATIENTS Seventy-nine children with short stature (height SD-score < -1.88) born small for gestational age (birth length SD-score < -1.88). MEASUREMENTS Before and during GH treatment, height, sitting height (SH), h and (Hand) and foot length (Foot), biacromial (Biac) and biiliacal diameter (Biil) were measured. All results were adjusted for age and sex, and expre ssed as SD-scores (SDS) using reference values for healthy Dutch children. To describe the size of SH, Hand, Foot, Biac, and Biil in relation to heigh t, these values were adjusted for the SDS of height. RESULTS At baseline, these short children had small hands and feet and narr ow shoulders and pelvis compared to healthy peers, Height and SH, were, how ever, even more affected. Consequently, on average, these children had rela tively large hands and feet, and relatively broad shoulders and pelvis comp ared to their height, but a normal sitting height in proportion to height. In most of the individuals, the values for body proportions were, however, within the normal range. During 6 years of GH treatment the SD-scores of al l measurements increased significantly towards values more close to zero. T he mean size of Hand, Foot, and Biil decreased in proportion to height. The mean SH increased relatively more than height, however, to values well wit hin the normal range. The mean Biac in relation to height had not changed a fter 6 years of GH treatment. No differences in the 6-year changes in body proportions were found between the two GH dosage groups. CONCLUSIONS Untreated short children born small for gestational age have, o n average, relatively large hands and feet, and broad shoulders and pelvis, but a normal sitting height compared to height. The increase in height dur ing 6 years of GH treatment is accompanied by an improvement of the proport ions of the size of hands, feet, and biiliacal diameter, in relation to hei ght. The increase in height appeared to be the result of the increase in si tting height as well as leg length, but the sitting height SD-score increas ed slightly more than that of leg length. The changes in body proportion du ring GH treatment were dose-independent. Thus, 6-year continuous GH treatme nt with either 3 or 6 IU/m(2)/day in children with short stature born small for gestational age does not negatively influence body proportions.