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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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