Growth hormone and fat distribution in SGA children

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Growth hormone has been used to promote growth in children born small for gestational age who do not have spontaneous catch-up growth. There has been a concern that hyperinsulinemia may be associated with growth hormone induced catch-up growth, particularly when a high dose of growth hormone is used.

In this issue of The Journal, De Schepper et al evaluated whether such catch-up growth is also associated with a more central distribution of fat. They found that children treated with growth hormone grew more in height and weight than untreated children. However, the treated children also developed a more central fat distribution. This could be a concern because central adiposity is associated with hyperinsulinemia and increased risk of cardiovascular disease and type 2 diabetes. Longer term follow-up will be required for these children.