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Decreased insulin sensitivity in SGA males treated with growth hormone and preterm untreated males. A study in young adults.

J Rotteveel, pediatrics, VU university medical center, Amsterdam, 1007 MB, Netherlands
M van Weissenbruch, pediatrics, VU university medical center, Amsterdam, Netherlands
H Delemarre - Van de Waal, pediatrics, VU university medical center, Amsterdam, Netherlands

Correspondence: Joost Rotteveel, Email: J.Rotteveel{at}VUmc.nl

Abstract

Background: Low birth weight and preterm birth are associated with growth delay as well as the development of insulin resistance. Insulin resistance is especially seen in subjects with catch up growth. Growth hormone therapy induces growth in short subjects with low birth weight at term, but little is known about the long term effects on insulin sensitivity. Growth hormone therapy is now proposed for preterms that remain short as well.

Methods: We investigated insulin sensitivity using the gold standard hyperinsulinaemic euglycemic clamp technique in 10 young adult males born SGA that had been treated with growth hormone during childhood (GH) in comparison with 15 males born preterm AGA (premAGA), 13 males born preterm SGA (premSGA) and 15 males born at term with normal birth weight (CON). Furthermore we investigated the presence of the metabolic syndrome.

Results: Insulin sensitivity was decreased in premAGA, premSGA and GH subjects compared to CON males. The metabolic syndrome was not present in any of the groups.

Conclusion: insulin sensitivity is decreased in GH-treated SGA born males as well as in preterm born males. With respect to the SGA subjects, whether the difference results from perinatal-, postnatal- or growth hormone therapy-related factors is not known. With respect to the preterm born subjects, close surveillance is needed when commencing growth hormone therapy.