Resistencia a insulina en pequeños para la edad gestacional tratados con hormona de crecimiento. Estudio observacional
Fecha de publicación2020-09
López Siguero, Juan P.
Martínez-Aedo, Maria J.
Bermúdez de la Vega, José A.
Lechuga-Sancho, Alfonso M.
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Background. In children born small for gestational age (SGA), the relationship between growth hormone (GH) treatment and insulin resistance [IR] has been investigated for a short-term period, being necessary a longer observation. Objectives. Evaluate the long-term (10 years) effect of the GH administered to SGA-children on IR and the safety during treatment. Methods. Multicenter observational study in SGA children receiving GH treatment in Spain (stratified by Tanner stage and age at GH onset [two groups: ≤6 years; >6 years]). Analyzed variables (yearly) included auxologic (growth velocity [GV]), metabolic (IGF-1, homeostatic model assessment- IR [HOMA-IR]), and safety ones. Data were collected prospectively since study approval (2007) and retrospectively from GH treatment onset (2005- 2007). Results. Interim analysis (6 years' follow-up) of 389 SGA children (369 Tanner I) from 27 centers. Mean age (SD) at GH treatment onset): 7.2 (3.1) years. IGF-1 (SDS) and HOMA-IR tended to increase until the sixth year with significant differences at the first year, and remaining stable thereafter (within normal ranges). Height (SDS) increased significantly (basal: -3.0; sixth year: -1.5); being the maximum GV at the first year (8.60 cm/year, with higher values in the ≤6 years group). Twenty-one adverse events were reported, two of them serious: type 2 diabetes, and osteonecrosis. Conclusions. The HOMA-IR increased significantly in SGA children during the first year of GH treatment, remaining stable later on, within normal ranges in any case. Our sixth-year data suggest that long-term GH treatment does not promote IR, is well tolerated, safe, and effective