Abstract：
BACKGROUND: Children born small for gestational age (SGA) not showing catch-up during the first two years of life reportedly show an impaired growth rate and adult height, as well as a worse metabolic outcome, mainly in terms of glycemic and lipid profile, compared to general population. In SGA children with short stature, treatment with recombinant growth hormone (GH) is currently recommended until adolescence; therefore, it may last long-term.
METHODS: The aim of the current study was to evaluate the auxological and metabolic effects and the safety of long-term recombinant GH treatment in SGA children. The study included 15 SGA children (5 F, 10 M; mean age: 6.78 yrs) treated with GH for at least 48 months. Growth and metabolic parameters, including glycemic and lipid profile, transaminases, and urycemia, were collected every six months.
RESULTS: Compared to baseline, SGA children showed a significant improvement in height, weight, and growth rate after four yaers of treatment with GH (p ≤ 0.002), being already evident after six months of treatment (p < 0.001). Noteworthy, patients showed a constant, significant improvement in height throughout the treatment, as it was significantly higher at each follow-up compared to the previous one, until 42 months of treatment, except at 30 months of treatment (p < 0.001 T6VST12; p < 0.01 T12VST18, T18VST24; p < 0.05 T30VST36, T36VST42). Considering metabolic parameters, compared to baseline, a recurring increase in glycemia (p ≤ 0.028 vs T30, T36, and T48) and decrease in AST (p ≤ 0.035 vs T36, T42, and T48) and an occasional decrease in LDL cholesterol (p ≤ 0.04 vs T24 and T42) and triglycerides (p = 0.008 vs T18) and increase in urycemia (p = 0.034 vs T42). Considering safety profile, treatment was well tolerated, as the most frequently reported adverse event was poor compliance (20%); no hyperglycemia, hypercholesterolemia or hyperstransaminasemia occurred throughout the treatment, CONCLUSIONS: Long-term GH treatment showed to be effective in improving height and growth rate in SGA children, with a positive impact of metabolic profile and a safety profile, although glycemia should be carefully monitored over time.
METHODS: The aim of the current study was to evaluate the auxological and metabolic effects and the safety of long-term recombinant GH treatment in SGA children. The study included 15 SGA children (5 F, 10 M; mean age: 6.78 yrs) treated with GH for at least 48 months. Growth and metabolic parameters, including glycemic and lipid profile, transaminases, and urycemia, were collected every six months.
RESULTS: Compared to baseline, SGA children showed a significant improvement in height, weight, and growth rate after four yaers of treatment with GH (p ≤ 0.002), being already evident after six months of treatment (p < 0.001). Noteworthy, patients showed a constant, significant improvement in height throughout the treatment, as it was significantly higher at each follow-up compared to the previous one, until 42 months of treatment, except at 30 months of treatment (p < 0.001 T6VST12; p < 0.01 T12VST18, T18VST24; p < 0.05 T30VST36, T36VST42). Considering metabolic parameters, compared to baseline, a recurring increase in glycemia (p ≤ 0.028 vs T30, T36, and T48) and decrease in AST (p ≤ 0.035 vs T36, T42, and T48) and an occasional decrease in LDL cholesterol (p ≤ 0.04 vs T24 and T42) and triglycerides (p = 0.008 vs T18) and increase in urycemia (p = 0.034 vs T42). Considering safety profile, treatment was well tolerated, as the most frequently reported adverse event was poor compliance (20%); no hyperglycemia, hypercholesterolemia or hyperstransaminasemia occurred throughout the treatment, CONCLUSIONS: Long-term GH treatment showed to be effective in improving height and growth rate in SGA children, with a positive impact of metabolic profile and a safety profile, although glycemia should be carefully monitored over time.
摘要：
背景：出生的小于胎龄的儿童（SGA）在出生后的头两年没有表现出追赶，据报道，其生长速度和成年身高均受损。以及更糟糕的代谢结果，主要是在血糖和血脂方面，与一般人口相比。在身材矮小的SGA儿童中，目前建议用重组生长激素（GH）治疗直到青春期;因此，它可能会长期持续。
方法：本研究的目的是评估长期重组GH治疗对SGA儿童的营养和代谢影响以及安全性。该研究包括15名SGA儿童(5F，10米；平均年龄：6.78岁）接受GH治疗至少48个月。生长和代谢参数，包括血糖和血脂，转氨酶，和尿酸血症,每六个月收集一次。
结果：与基线相比，SGA儿童的身高显着改善，体重,用GH治疗四次后的生长速率（p≤0.002），在治疗六个月后已经很明显（p<0.001）。值得注意的是,患者表现出恒定的，在整个治疗过程中高度显著改善，因为每次随访都明显高于上一次，直到42个月的治疗,治疗30个月时除外（p<0.001T6VST12；p<0.01T12VST18，T18VST24；p<0.05T30VST36，T36VST42）。考虑到代谢参数，与基线相比，血糖反复升高(p≤0.028vsT30,T36和T48),AST降低(p≤0.035vsT36,T42和T48),LDL胆固醇(p≤0.04vsT24和T42)和甘油三酯(p=0.008vsT18)偶尔降低,尿酸血症升高(p=0.034vsT42).考虑到安全性，治疗耐受性良好，因为最常报告的不良事件是依从性差(20%);没有高血糖,在整个治疗过程中都会出现高胆固醇血症或高血压。结论：长期GH治疗可有效改善SGA儿童的身高和生长速度，代谢概况和安全概况的积极影响，尽管血糖应该随着时间的推移而仔细监测。
方法：本研究的目的是评估长期重组GH治疗对SGA儿童的营养和代谢影响以及安全性。该研究包括15名SGA儿童(5F，10米；平均年龄：6.78岁）接受GH治疗至少48个月。生长和代谢参数，包括血糖和血脂，转氨酶，和尿酸血症,每六个月收集一次。
结果：与基线相比，SGA儿童的身高显着改善，体重,用GH治疗四次后的生长速率（p≤0.002），在治疗六个月后已经很明显（p<0.001）。值得注意的是,患者表现出恒定的，在整个治疗过程中高度显著改善，因为每次随访都明显高于上一次，直到42个月的治疗,治疗30个月时除外（p<0.001T6VST12；p<0.01T12VST18，T18VST24；p<0.05T30VST36，T36VST42）。考虑到代谢参数，与基线相比，血糖反复升高(p≤0.028vsT30,T36和T48),AST降低(p≤0.035vsT36,T42和T48),LDL胆固醇(p≤0.04vsT24和T42)和甘油三酯(p=0.008vsT18)偶尔降低,尿酸血症升高(p=0.034vsT42).考虑到安全性，治疗耐受性良好，因为最常报告的不良事件是依从性差(20%);没有高血糖,在整个治疗过程中都会出现高胆固醇血症或高血压。结论：长期GH治疗可有效改善SGA儿童的身高和生长速度，代谢概况和安全概况的积极影响，尽管血糖应该随着时间的推移而仔细监测。
