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Children born SGA receiving growth hormone have similarly impaired glucose-insulin metabolism as children with obesity.
J. Clin. Endocrinol. Metab.:dgaf672 (2026)
CONTEXT: Being born small for gestational age (SGA) and growth hormone (GH) treatment are linked to disturbed glucose-insulin metabolism. OBJECTIVE: We investigated how GH treatment affects glucose-insulin metabolism in children born SGA compared to children with isolated growth hormone deficiency (iGHD), obesity and lean controls. METHODS: We analyzed glucose-insulin metabolism indices derived from oral glucose tolerance tests (Matsuda index, AUC insulin) and fasting parameters (fasting glucose, HOMA-IR) in 134 SGA patients without catch-up growth (CUG) receiving GH therapy (SGA-GHT), 27 untreated SGA patients with catch-up growth (SGA-CUG), 308 iGHD patients under GH treatment, 427 children with obesity, and 356 lean controls. We adjusted for sex, age, and BMI through matching and multivariable regression. RESULTS: Treatment-naïve SGA-GHT patients were more insulin-resistant than iGHD patients (higher insulin AUC [P = .002] and HOMA-IR [P < .001], lower Matsuda index [P < .001]) with levels approaching those of the obesity cohort. Under GH therapy, HbA1c was higher in SGA-GHT and iGHD patients (5.26% ± 0.35 vs 5.25% ± 0.25) than in lean controls (5.09% ± 0.27). Insulin resistance in SGA-GHT patients approached levels seen in obesity. Prediabetes prevalence was highest in SGA-GHT children (11.11%) compared to those with iGHD (1.59%) or obesity (3.13%). After stopping GH therapy, SGA-GHT patients retained elevated markers of prediabetes (4.65%) and insulin resistance compared to controls and iGHD patients, similar to children with obesity (6.38%). No overt type 2 diabetes was observed. CONCLUSION: SGA patients have an impaired glucose-insulin metabolism similar to that of children with obesity, which worsens under GH therapy. Close metabolic monitoring of GH-treated SGA patients is recommended.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Diabetes ; Growth Hormone Deficiency ; Growth Hormone Therapy ; Insulin Resistance ; Obesity ; Small For Gestational Age; For-gestational-age; Catch-up Growth; Diabetes-mellitus; Cardiovascular Risk; Resistance; Sensitivity; Adolescents; Tolerance; Adulthood; Weight
ISSN (print) / ISBN
0021-972X
e-ISSN
1945-7197
Quellenangaben
Artikelnummer: dgaf672
Verlag
Endocrine Society
Verlagsort
Bethesda, Md.
Begutachtungsstatus
Peer reviewed
Institut(e)
Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Förderungen
University Leipzig
German Diabetes Association
Biomarin
NovoNordisk
Hexal
German Center for Child and Adolescent Health
Federal Ministry of Research, Technology and Space
German Diabetes Association
Biomarin
NovoNordisk
Hexal
German Center for Child and Adolescent Health
Federal Ministry of Research, Technology and Space