B O D Y P R O P O R T I O N S I N S M A L L F O R G E S T A T I O N A L A G E C H I L D R E N A F T E R R E C E I V I N G G R O W T H H O R M O N E T R E A T M E N T Chapter 4 Body proportions in small for gestational age children after receiving growth hormone treatment CHAPTER 4 Body proportions in small for gestational age children after receiving growth hormone treatment It is generally accepted that children born small for gestational age (SGA) have a higher risk to develop the metabolic syndrome with insulin resistance and cardiovascular diseases. At the same time it is know that a lot of SGA children show an accelerating weight gain, but no abnormal gain in length. The same is true for an increasing number of children born appropriate for gestational age (AGA) who develop obesity. As described in the previous chapter there is no secular trend in weight and length during the perinatal period. Therefore, there seems to be a common factor in the growth of both infant groups, SGA and AGA. The SGA children who not correct their length during the first years of life and end up at the age of four years with height below two standard deviations, are eligible for treatment with recombinant human growth hormone (rhGH). It is of interest to investigate if these SGA children will change their body propor-‐ tions in the sense of body mass index (BMI) after receiving rhGH. To examine the pattern of changes in body proportions BMI and weight for height SDS values after 1 year of rhGH treatment were calculated. As golden standard of the body composition in the sense of fat-‐free mass, the Deuterium dilution method was applied. The change of the body composition after treatment with rhGH measured by the Deuterium method is compared with the change in BMI. The results of this comparison are important in the approach to the prevention of the metabolic syndrome in SGA children as well as in the AGA children. Evidently the simple measurement of the BMI is a good tool for health care practitioners not only in the SGA group but also in the AGA children. This chapter is submitted for publication by: Manon AB Ernst, Angèle JGM Gerver, Luc JI Zimmermann, Willem JM Gerver. 59
Proefschrift binnenwerk Manon Ernst_DEF.indd
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