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 푆푆푆푆푆푆푡푡 = 푥푥푡푡 !푚푚푡푡 푠푠푡푡 where xt denotes body measurement score at age t, mt the population mean at age t and st the SD of the reference population at age t. As reference population the Dutch reference values of Gerver et al. were used19. As the metabolic effect parameter, total body water (TBW) was measured with the Deuterium dilution technique before and at 6 weeks after start of therapy. To inter-‐ pret total body water in individuals who differed in height, the results were cor-‐ rected for height as TBW/height2. Total body water was measured with the stable isotope of hydrogen according to the Maastricht protocol20 and calculated by 퐶퐶!×푉푉! = 퐶퐶!×푉푉! C1 = concentration of the label in the ingested fluid V1 = volume of the dose C2 = concentration of the tracer in the sample V2 = distribution volume in the body Due to the exchange of the tracer with non-‐aqueous substances in the body, V2 has to be divided by 1.04 to determine TBW. A comparison was made between the change in TBW after six weeks with the change in BMI after 1 year of treatment with rhGH (Figure 1). We also compared the change in TBW after six weeks with the change in weight for height, 1 year after treatment with rhGH (Figure 2). Results We included 22 SGA children in our study population. Those children met the crite-‐ ria to receive rhGH treatment. The mean change in BMI after 1 year of rhGH treat-‐ ment was -‐0.04 kg/m2. The mean change in SDS in weight for height values for the-‐ se children after 1 year of rhGH treatment was 0.11 SD. Because two individuals showed deviating values, these values were excluded in our next calculations. The mean age of the remaining 20 children at which rhGH treatment started was: 5.5 years. The mean change in BMI after 1 year of rhGH treatment was 0 kg/m2. The mean change in SDS in weight for height values for these children after 1 year of rhGH treatment was 0.17 SD and the mean change in SDS in height values for these chil-‐ 63
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