NESGAS is being organised in the UK by the British Society for Paediatric Endocrinology (BSPED) in collaboration with Paediatric Endocrinologists in Denmark, Ireland and Sweden.
Children born small for gestational age (SGA) have an increased risk of short adult stature.
Several studies have shown that both children and adults born SGA have reduced insulin sensitivity. Adults born SGA have an increased risk of insulin resistance and type 2 diabetes.
Growth hormone treatment improves both short and long-term height gain. However it has also been shown to further reduce insulin sensitivity and the long term outcome of this remains unclear with one study demonstrating recovery of insulin sensitivity once growth hormone therapy was completed and another not. Careful monitoring during and after treatment is therefore required.
Suggested doses of growth hormone doses for children born SGA without catch-up growth vary from 35 to 67 µg/kg/day across Europe.
Aim of Study
To evaluate in short children born SGA:
- Different growth hormone doses (low vs. high vs. IGF-1 titrated dose) on short-term height velocity, final height and insulin sensitivity
- Auxological, biochemical and genetic predictors of growth response and effects on insulin resistance following growth hormone therapy
- Long-term effects and safety of childhood growth hormone therapy evaluated in adulthood (5 and 10 years after attaining final height)
The primary objective is to evaluate changes in insulin sensitivity and secretion and incidence of impaired glucose tolerance in short children born SGA. This will be assessed by annual oral glucose tolerance tests (OGTT) alternating with intravenous glucose tolerance tests (IVGTT). Insulin sensitivity will be assessed by HOMA and first phase insulin secretion will be assessed during long term growth hormone treatment.
For more information please contact Catherine Fullah