J Clin Endocrinol Metab., 2008; 93(8): 2978-83, PMID: 18505766
Muscle function improves during growth hormone therapy in short children born small for gestational age: results of a peripheral quantitative computed tomography study on body composition
Schweizer R, Martin DD, Schönau E, Ranke MB
Pediatric Endocrinology Section, University Hospital for Children and Adolescents, Hoppe Seyler Strasse 1, D-72076 Tuebingen, Germany. Roland.Schweizer@med.uni-tuebingen.de
Abstract
BACKGROUND: Short small for gestational age (SGA) children can be affected by a lack of muscle mass rather than fat mass. They also face a high risk of the metabolic syndrome developing after childhood. It is not known whether low muscle mass influences muscle function. AIM: Our aim was to investigate muscle-fat distribution and muscle function before and during GH treatment in short SGA children. PATIENTS: A total of 34 prepubertal short SGA children (11 females, seven with Silver-Russell syndrome) were included in the study. Mean values were: age at GH start 7.3 yr; height sd score (SDS) -3.3; and birth weight SDS -2.7. METHODS: Investigations over 24 months on GH treatment (57 microg/kg.d) were performed. Body composition, including fat area and muscle area (MA), was assessed through peripheral quantitative computed tomography (XCT 2000; Stratec, Inc., Pforzheim, Germany). Maximal isometric grip force was performed with a Jamar dynamometer (Preston, Jackson, MI). Comparison with height-dependent reference values (SDS(Height)) was calculated. RESULTS: MA SDS(Height) at GH start was -1.8 and increased to -0.8 (P < 0.001) and -0.8, and fat area SDS(Height) decreased from -0.6 to -2.0 (P < 0.001) and -1.5 after 12 and 24 months on GH. Maximal isometric grip force SDS(Height) increased from -0.9 to 0.3 (P < 0.001) and 0.5. MA at start correlated negatively with height velocity (R = -0.54; P < 0.001) and MA SDS at start and Delta-height SDS during the first year of GH treatment (R = -0.40; P < 0.001). CONCLUSIONS: Short stature in SGA children is associated with low muscle mass and function. Supraphysiological GH doses led to a concomitant increment in height, muscle mass, and function, whereas fat mass decreased. Furthermore, body composition at GH start gives insight into GH responsiveness and the individual risk of metabolic syndrome.Produktgruppen: pQCT Knochendichte & -geometrie
Themen: Klinische Studien, Klinische Anwendung, Pädiatrie, Medizinische Fachbereiche, Diagnostik mit Leonardo & pQCT, Therapie & Prävention mit Galileo®
Schlagworte: muscle groth hormone, growth retardation
Doc-ID: 1515, 09.09.2008
