Resistencia a insulina en pequeños para la edad gestacional tratados con hormona de crecimiento. Estudio observacional

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 adminis...

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Detalles Bibliográficos
Autores: López Siguero, Juan P., Martínez-Aedo, Maria J., Bermúdez de la Vega, José A., Bosch Muñoz, Jordi, Lechuga-Sancho, Alfonso M., Fernandez-González, Ana, Villalobos, Triana
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/70922
Acceso en línea:https://doi.org/10.3266/RevEspEndocrinolPediatr.pre2020.Sep.589
http://hdl.handle.net/10459.1/70922
Access Level:acceso abierto
Palabra clave:HOMA
Hormona de crecimiento
Sensibilidad a insulina
Descripción
Sumario: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