Long-term growth hormone exposure poses no risk of insulin resistance in kids born SGA

In children born small for gestational age (SGA), long-term treatment with recombinant human growth hormone (rhGH) does not carry an excess risk of insulin resistance (IR), according to 10-year data from a study.

The observational study included 389 SGA children (mean age at treatment initiation 7.2 years, 50.4 percent boys), among whom 369 were at Tanner-I stage. The children had a current height of <−2.5 standard deviation SD, weight and/or length at birth of <−2 SD for their gestational age, and receiving rhGH treatment at a daily dose of 0.035 mg/kg body weight subcutaneously.

None of the participants had closed epiphysis, rhGH-hypersensitivity, active neoplasia, genetic or malformation syndromes, and evidence of progression or recurrence of any underlying intracranial lesion.

Researchers measured auxologic and metabolic (insulin-like growth factor-1 [IGF-1], height velocity, weight, and homeostatic model assessment-IR [HOMA-IR]) variables and safety data.

Results showed that IGF-1 (SD score [SDS]) and HOMA-IR values increased significantly within the first year of rhGH treatment, with the increase persisting until the sixth year. However, the values remained stable in the later years and within normal ranges.

Height increased significantly from −3.0 SDS at baseline to −1.13 at year 10, with the maximum height velocity occurring during the first year of treatment (2.75 SDS).

The present data suggest that rhGH treatment in the long term is safe and effective at normalizing height.