Abstract:
OBJECTIVE:To assess possible side-effects of long-term continuous growth hormone (GH) treatment on carbohydrate (CH) metabolism in children with short stature born small for gestational age. DESIGN:In a prospective, randomised double-blind, dose-response multicentre trial, the effect of GH treatment on CH metabolism was evaluated, comparing two GH dosages [3 vs. 6 IU/(m(2) body surface.day)]. PATIENTS:Seventy-eight children with short stature (height SD-score < - 1.88) born small for gestational age (birth length SD-score < - 1.88) being all prepubertal with a mean (SD) chronological age of 7.3 (2.2) years before start of treatment. MEASUREMENTS:Glucose and insulin concentrations during oral glucose tolerance tests (OGTTs) and glycosylated haemoglobin (HbA(1c)) were measured before and during 6 years of GH treatment. RESULTS:Before treatment, the glucose response to oral glucose after 120 min was in six of the 78 children (8%) above 7.8 mmol/l but below 11.1 mmol/l, indicating impaired glucose tolerance (IGT), whereas after 6 years of GH treatment, IGT was found in 4% of the children. None of the children developed diabetes mellitus. Mean fasting glucose levels had increased significantly by 0.5 mmol/l after 1 year of GH treatment, without a further increase thereafter. The 2-h area under the curve adjusted for fasting levels (AUCab) for glucose and the HbA(1c) levels were lower after 6 years of GH treatment compared to baseline. During GH treatment, all HbA(1c) levels were in the normal range. In contrast to the effects on glucose levels, GH treatment induced considerably higher fasting insulin levels and glucose-stimulated insulin levels. The increase in AUCab for insulin occurred particularly during the first year of treatment, whereas the fasting insulin levels showed a further increase from one to six years. As a result, the 30- and 120-min ratios of insulin to glucose were higher during GH treatment compared to the start of treatment. The children who remained prepubertal during the entire study period showed similar patterns in glucose and insulin levels compared to the children who entered puberty. None of the observed changes were different between the GH dosage groups. CONCLUSIONS:Continuous GH treatment during 6 years in children with short stature born small for gestational age has no adverse effects on glucose levels, even with dosages up to 6 IU/(m(2) d). However, as has been reported in other patient groups, GH treatment induces higher fasting insulin levels and glucose-stimulated insulin levels, indicating relative insulin resistance. Since the consequences of long-term hyperinsulinism during childhood are unknown, careful follow-up of these GH-treated children born small for gestational age is required.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Sas T,Mulder P,Aanstoot HJ,Houdijk M,Jansen M,Reeser M,Hokken-Koelega Adoi
10.1046/j.1365-2265.2001.01178.xkeywords:
subject
Has Abstractpub_date
2001-02-01 00:00:00pages
243-51issue
2eissn
0300-0664issn
1365-2265pii
cen1178journal_volume
54pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:Women with impaired glucose tolerance (IGT) and type 2 diabetes (T2D) are more at risk of cardiovascular disease. The aim of this study was to test the hypothesis that increased visceral adipose tissue (VAT) could explain to a large extent alterations in the cardiovascular disease risk profile of postmenopaus...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2010.03933.x
更新日期:2011-03-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1992.tb00955.x
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:The diagnosis of growth hormone deficiency (GHD) in adults is established through growth hormone (GH) stimulation testing, which is often complex, expensive, time-consuming and may be associated with adverse side effects. The decision to perform GH provocative testing is influenced by clinical findings, medic...
journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.2007.03082.x
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:Data about GnRHa on adult height in girls with central precocious puberty(CPP) have shown variable results, ranging from improvement of growth prognosis to lack of any benefit.This study was designed to delineate the criteria to decide which girls with idiopathic CPP(iCPP) will have a height benefit from GnRH...
journal_title:Clinical endocrinology
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doi:10.1111/cen.14420
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1993.tb02391.x
更新日期:1993-10-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2265.1984.tb00086.x
更新日期:1984-03-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1990.tb00886.x
更新日期:1990-04-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/cen.12306
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doi:10.1046/j.1365-2265.2002.01609.x
更新日期:2002-09-01 00:00:00
abstract::Thyroid status was estimated serially by measuring triiodothyronine (T3), thyroxine (T4) and thyrotrophin (hTSH) in 20 patients suffering from meningococcal meningitis, typhoid fever and other acute febrile illnesses. Significantly low T3 and only slightly increased T4 were observed in all the patients. hTSH was norma...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb03579.x
更新日期:1978-11-01 00:00:00
abstract::Men with hypogonadotropic hypogonadism (HH) are typically azoospermic, and yet HH is one of the few treatable forms of male infertility. Sperm induction protocols using gonadotrophins aim to replicate the natural endocrine control of spermatogenesis. Previously virilised men with adult-onset HH and normal testicular v...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/cen.13850
更新日期:2018-12-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1994.tb02442.x
更新日期:1994-01-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.2009.03558.x
更新日期:2009-11-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1365-2265.2003.01718.x
更新日期:2003-03-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12101
更新日期:2013-11-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2265.1995.tb02670.x
更新日期:1995-05-01 00:00:00
abstract::The results obtained with a new test of prolactin (PRL) release in six panhypopituitary patients as compared to fourteen normal subjects (eight females and six males) are presented. The test consists of the i.m. administration of 100 mg of sulpiride and the measurement of plasma PRL by a double antibody radioimmunoass...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb01494.x
更新日期:1978-03-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1993.tb01755.x
更新日期:1993-07-01 00:00:00
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doi:10.1111/cen.14341
更新日期:2020-09-27 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12732
更新日期:2015-06-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2006.02710.x
更新日期:2007-02-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2005.02367.x
更新日期:2005-10-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.2001.01245.x
更新日期:2001-04-01 00:00:00
abstract::Serum levels of thyroxine and triiodothyronine during pregnancy were measured in women from a severely iodine deficient region in the highlands of Papua New Guinea. Subsequently the children born to these women were examined when aged 10-12 years and measures made of intellectual ability and motor competence. A signif...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1984.tb03468.x
更新日期:1984-09-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2011.04084.x
更新日期:2011-10-01 00:00:00
abstract::The urine clearance of TRH after intravenous injection in man has been measured by radioimmunoassay. Between 4.4 percent and 10.7 percent of the dose was excreted within 90 min, the majority within 30 min. The TRH excreted was immunochemically and chromatographically indistinguishable from synthetic TRH and was inacti...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1975.tb01549.x
更新日期:1975-07-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12224
更新日期:2013-11-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.2002.01553.x
更新日期:2002-06-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2265.2010.03943.x
更新日期:2011-04-01 00:00:00