scholarly journals Increases in Bioactive IGF do not Parallel Increases in Total IGF-I During Growth Hormone Treatment of Children Born SGA

2019 ◽  
Vol 105 (4) ◽  
pp. e1291-e1298 ◽  
Author(s):  
Mathilde Gersel Wegmann ◽  
Rikke Beck Jensen ◽  
Ajay Thankamony ◽  
Jan Frystyk ◽  
Edna Roche ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Receptor Activation ◽  
High Dose ◽  
Reference Ranges ◽  
Gh Treatment ◽  
Normal Reference ◽  
Igf I ◽  
One Year

Abstract Background Some children born small for gestational age (SGA) experience supra-physiological insulin-like growth factor-I (IGF-I) concentrations during GH treatment. However, measurements of total IGF-I concentrations may not reflect the bioactive fraction of IGF-I which reaches the IGF-I receptor at target organs. We examined endogenous IGF-bioactivity using an IGF-I kinase receptor activation (KIRA) assay that measures the ability of IGF-I to activate the IGF-IR in vitro. Aim To compare responses of bioactive IGF and total IGF-I concentrations in short GH treated SGA children in the North European Small for Gestational Age Study (NESGAS). Material and method In NESGAS, short SGA children (n = 101, 61 males) received GH at 67 µg/kg/day for 1 year. IGF-I concentrations were measured by Immulite immunoassay and bioactive IGF by in-house KIRA assay. Results Bioactive IGF increased with age in healthy pre-pubertal children (n = 94). SGA children had low-normal bioactive IGF levels at baseline (-0.12 (1.8 SD), increasing significantly after one year of high-dose GH treatment to 1.1 (1.4) SD, P < 0.01. Following high-dose GH, 68% (n = 65) of SGA children had a total IGF-I concentration >2SD (mean IGF-I 2.8 SDS), whereas only 15% (n = 15) had levels of bioactive IGF slightly above normal reference values. At baseline, bioactive IGF (SDS) was significantly correlated to height (SDS) (r = 0.29, P = 0.005), in contrast to IGF-I (SDS) (r = 0.17, P = 0.10). IGF-I (SDS) was inversely correlated to delta height (SDS) after one year of high-dose GH treatment (r = -0.22, P = 0.02). Conclusion In contrast to total IGF-I concentrations, bioactive IGF stayed within the normal reference ranges for most SGA children during the first year of GH treatment.

scholarly journals High Serum Levels of Growth Hormone (GH) and Insulin-Like Growth Factor-I (IGF-I) during High-Dose GH Treatment in Short Children Born Small for Gestational Age

2006 ◽  
Vol 91 (4) ◽  
pp. 1390-1396 ◽  
Author(s):  
Marije van Dijk ◽  
Paul Mulder ◽  
Mieke Houdijk ◽  
Jaap Mulder ◽  
Kees Noordam ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Serum Levels ◽  
High Serum ◽  
High Dose ◽  
Gh Treatment ◽  
Igf I ◽  
Group A ◽  
Group B ◽  
Igfbp 3

Context: Epidemiological studies have indicated that high serum levels of GH and IGF-I are associated with long-term risks. Objective: The objective of the study was to evaluate the changes in serum levels of GH during overnight profiles, IGF-I, and IGF binding protein 3 (IGFBP-3) in short small for gestational age (SGA) children during GH treatment with two doses. Patients: Thirty-six prepubertal short SGA children were the subjects of this study. Intervention: Subjects received 1 (group A) or 2 (group B) mg GH/m2·d. Main Outcome Measures: At baseline and after 6 months of GH treatment, overnight GH profiles were performed, and serum IGF-I and IGFBP-3 levels were measured. Results: After 6 months, group B had significantly higher GH levels during the profile (mean, maximum, and area under the curve above zero line) than group A (P < 0.009). In group B, maximum GH levels increased from 43.9–161 mU/liter (P < 0.0002), and in group A, from 57.2–104 mU/liter (P = 0.002). During the profile (i.e. 12 h per day), children of group B had mean GH levels of 64.4 vs. 34.8 mU/liter in group A (P = 0.001). The IGF-I and IGF-I to IGFBP-3 ratio sd scores increased significantly in both groups, but were higher in group B than A [1.5 vs. 0.2 (P = 0.002) and 1.4 vs. 0.3 (P = 0.007), respectively]. In group B, 74% of the children had IGF-I levels in the highest quintile during GH treatment compared with 19% in group A. Conclusion: Our study shows that high-dose GH treatment in short SGA children results in high serum GH and IGF-I levels in most children. We recommend monitoring IGF-I levels during GH therapy to ensure that these remain within the normal range.

scholarly journals Metabolic implications of GH treatment in small for gestational age

2007 ◽  
Vol 157 (suppl_1) ◽  
pp. S47-S50 ◽  
Author(s):  
E M Delemarre ◽  
J Rotteveel ◽  
H A Delemarre-van de Waal
Keyword(s):  
Lipid Metabolism ◽  
Gestational Age ◽  
Growth Retardation ◽  
Small For Gestational Age ◽  
Postnatal Growth ◽  
Gh Treatment ◽  
Increased Risk ◽  
Igf I

Fetal growth retardation is associated with decreased postnatal growth, resulting in a lower adult height. In addition, a low birth weight is associated with an increased risk of developing diseases during adulthood, such as insulin resistance, type 2 diabetes mellitus, hypertension, dyslipidemia, and cardiovascular diseases. Children with persistent postnatal growth retardation, i.e., incomplete catchup growth, can be treated with human GH. The GH/IGF-I axis is involved in the regulation of carbohydrate and lipid metabolism. The question of whether treatment with GH in children born small for gestational age (SGA) has long-term implications with respect to glucose/insulin and lipid metabolism has not been answered yet. In this article, the available data are reviewed.

scholarly journals One-Year Data from a Long-Term Phase IV Study of Recombinant Human Growth Hormone in Short Children Born Small for Gestational Age

2014 ◽  
Vol 4 (1-2) ◽  
pp. 1-13 ◽  
Author(s):  
Hans-Peter Schwarz ◽  
Dorota Birkholz-Walerzak ◽  
Mieczyslaw Szalecki ◽  
Mieczyslaw Walczak ◽  
Corina Galesanu ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Human Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Short Children ◽  
One Year ◽  
Phase Iv

scholarly journals Metabolic and immunological assessment of small-for-gestational-age children during one-year treatment with growth hormone: the clinical impact of apolipoproteins

2018 ◽  
Vol 65 (4) ◽  
pp. 449-459 ◽  
Author(s):  
Kanako Kojima-Ishii ◽  
Naoko Toda ◽  
Kazuhiro Okubo ◽  
Vlad Tocan ◽  
Noriko Ohyama ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Clinical Impact ◽  
One Year

Serum Thymic Hormone Activity and Cell-Mediated Immunity in Healthy Neonates, Preterm Infants, and Small-for-Gestational Age Infants

PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 407-411
Author(s):  
R. K. Chandra
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lymphocyte Stimulation ◽  
Cell Mediated Immunity ◽  
Low Birth Weight Infants ◽  
Thymic Hormone ◽  
Appropriate For Gestational Age

Groups of healthy, small-for-gestational age (SGA) and preterm appropriate-for-gestational age (AGA) infants were studied at birth, 1 month, 3 months, and 12 months of age. Serum thymic hormone (TH) activity was assayed, the number of T lymphocytes in the peripheral blood was counted, and in vitro lymphocyte stimulation responses to phytohemagglutinin (PHA) were evaluated. TH activity was decreased in 1-month-old SGA infants. T cells were reduced in all low birth weight infants; the number reverted to normal by 3 months of age in preterm AGA infants, whereas it remained low for at least 12 months in the SGA group. Lymphocyte stimulation response was decreased in low birth weight infants; the extent of depression paralleled reduction in T lymphocyte number. These observations indicate that cell-mediated immunity is impaired in low birth weight newborns and reduced TH activity may be one of the pathogenetic factors involved. Persistent depression of immunocompetence may underlie the increased susceptibility of SGA infants to infection-related morbidity and mortality.

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