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Baseline IGF-I Levels Determine Insulin Secretion and Insulin Sensitivity during the First Year on Growth Hormone Therapy in Children Born Small for Gestational Age. Results from a North European Multicentre Study (NESGAS)

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Authors:
  • Jensen, Rikke Beck ;
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    Department of Growth and Reproduction, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
  • Thankamony, Ajay ;
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    unknown
  • O'Connell, Susan M ;
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    unknown
  • Salgin, Burak ;
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    unknown
  • Kirk, Jeremy ;
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    unknown
  • Donaldson, Malcolm ;
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    unknown
  • Ivarsson, Sten-A ;
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    unknown
  • Söder, Olle ;
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    unknown
  • Roche, Edna ;
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    unknown
  • Hoey, Hilary ;
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    unknown
  • Dunger, David B ;
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    unknown
  • Holm, Kirsten ;
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    Paediatrics, Department of, Nordsjællands Hospital, The Capital Region of Denmark
  • Juul, Anders
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    Department of Growth and Reproduction, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
DOI:
10.1159/000353438
Abstract:
Objective: Developmental programming alters growth and metabolic outcome in children born small for gestational age (SGA). We explored insulin and glucose metabolism in SGA children treated with a fixed GH dose over 1 year. Methods: In the North European Small for Gestational Age Study (NESGAS), 110 short SGA children received GH at 67 µg/kg/day for 1 year. Insulin secretion was assessed by acute insulin response (AIR), insulin sensitivity (IS) by HOMA and disposition index (DI) by insulin secretion adjusted for IS. Results: First-year GH therapy led to increases in height and IGF-I standard deviation score (SDS), and reductions in IS (p <0.0001). Compensatory increases in AIR (p <0.0001) were insufficient and resulted in reduced DI (p = 0.032). Children in the highest IGF-I SDS tertile at baseline were the least insulin sensitive at baseline (p = 0.024) and 1 year (p = 0.006). IGF-I responses after 1 year were positively related to AIR (r = 0.30, p = 0.007) and DI (r = 0.29, p = 0.005). Conclusion: In SGA children treated with a high GH dose for 1 year, baseline IGF-I levels were related to IS whilst gains in height and IGF-I responses were associated with insulin secretion. Defining heterogeneity in IGF-I in SGA children may be useful in predicting growth and metabolic response.
Type:
Journal article
Language:
English
Published in:
Hormone Research in Paediatrics, 2013, Vol 80, Issue 1, p. 38-46
Keywords:
Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2013
Scientific Level:
Scientific
ID:
244299725

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