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Roland Schweizer, David D. Martin, Eckhard Schönau, Michael B. Ranke, 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, The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 8, 1 August 2008, Pages 2978–2983, https://doi.org/10.1210/jc.2007-2600
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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 μg/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 (SDSHeight) was calculated.
Results: MA SDSHeight at GH start was −1.8 and increased to −0.8 (P < 0.001) and −0.8, and fat area SDSHeight decreased from −0.6 to −2.0 (P < 0.001) and −1.5 after 12 and 24 months on GH. Maximal isometric grip force SDSHeight 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 Δ-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.
