Eduardo Gutiérrez-Abejón1, Eva P Campo-Ortega2, Pablo Prieto-Matos3, María P Bahíllo-Curieses4, María T Breñas-Villalón2, Nieves Martín-Sobrino5. 1. Servicio de Concierto Farmacéutico y Otras Prestaciones, Dirección Técnica de Asistencia Farmacéutica, Dirección General de Asistencia Sanitaria, Gerencia Regional de Salud de Castilla y León, Valladolid, España. Electronic address: egutiabe@gmail.com. 2. Servicio de Concierto Farmacéutico y Otras Prestaciones, Dirección Técnica de Asistencia Farmacéutica, Dirección General de Asistencia Sanitaria, Gerencia Regional de Salud de Castilla y León, Valladolid, España. 3. Servicio de Pediatría, Hospital Clínico Universitario de Salamanca, Salamanca, España. 4. Servicio de Pediatría, Hospital Clínico Universitario de Valladolid, Valladolid, España. 5. Dirección Técnica de Asistencia Farmacéutica, Dirección General de Asistencia Sanitaria. Gerencia Regional de Salud de Castilla y León, Valladolid, España.
Abstract
INTRODUCTION AND OBJECTIVES: Growth hormone (rhGH) is used in children with intrauterine growth retardation without catch-up growth. The Advisory Committee of Castilla y León was implemented in 2010 to watch for consistent application of the criteria for using rhGH. The aim is to assess anthropometric and clinical changes in children treated with growth hormone. PATIENTS AND METHODS: A retrospective, longitudinal study of patients diagnosed with intrauterine growth retardation without catch-up growth in Castilla y León since 2010 who have received treatment for at least 3 years. Changes in anthropometric, clinical, and laboratory parameters were assessed. RESULTS: Forty-three children with a mean age of 6.06 years (58.14%<5 years) were enrolled and treated with a mean dose of 0.038mg/kg/day. A significant increase was seen in height (-3.05 to -1.58SD). Both weight and BMI (14.51 to 15.80kg/m2) increased throughout the study. Growth rate peaked during the first year of treatment (0.74SD). IGF-1 levels increased throughout the study (99.96 to 392.88ng/mL). There were significant increases in glycosylated hemoglobin levels in the first year, and in basal blood glucose and insulin levels during the second year. The LDL/HDL ratio decreased during the study period (1.70 to 1.50). CONCLUSION: Treatment with rhGH promotes growth in children with intrauterine growth retardation. Peak effect occurs in the first 12 months of treatment, and is greater when growth hormone is started before the age of 5 years.
INTRODUCTION AND OBJECTIVES:Growth hormone (rhGH) is used in children with intrauterine growth retardation without catch-up growth. The Advisory Committee of Castilla y León was implemented in 2010 to watch for consistent application of the criteria for using rhGH. The aim is to assess anthropometric and clinical changes in children treated with growth hormone. PATIENTS AND METHODS: A retrospective, longitudinal study of patients diagnosed with intrauterine growth retardation without catch-up growth in Castilla y León since 2010 who have received treatment for at least 3 years. Changes in anthropometric, clinical, and laboratory parameters were assessed. RESULTS: Forty-three children with a mean age of 6.06 years (58.14%<5 years) were enrolled and treated with a mean dose of 0.038mg/kg/day. A significant increase was seen in height (-3.05 to -1.58SD). Both weight and BMI (14.51 to 15.80kg/m2) increased throughout the study. Growth rate peaked during the first year of treatment (0.74SD). IGF-1 levels increased throughout the study (99.96 to 392.88ng/mL). There were significant increases in glycosylated hemoglobin levels in the first year, and in basal blood glucose and insulin levels during the second year. The LDL/HDL ratio decreased during the study period (1.70 to 1.50). CONCLUSION: Treatment with rhGH promotes growth in children with intrauterine growth retardation. Peak effect occurs in the first 12 months of treatment, and is greater when growth hormone is started before the age of 5 years.