C H A P T E R 4 66 Figure 2: Change in weight for height (SDS), after 1 year of rhGH treatment, plotted against the change in TBW/ height2(l/m2), 6 weeks after the start of rhGH treatment. Discussion The present study of 20 SGA children showed a change in TBW after six weeks of treatment with rhGH of 0.62 as well as a change in height one year thereafter of 0.81 SDS. These results are comparable with the nationwide Dutch study of Ernst et al15 of 99 SGA children where the treatment with rhGH of SGA children results in a change of the TBW with 0.68 SDS after six weeks and an increase in height, one year after rhGH treatment of 0.87 SDS. SGA children are treated with rhGH primarily to repair their small height. At the same time monitoring of weight in relation to height is also of great importance, because SGA children are prone to increase their weight outside the normal range. This increase must be prevented to reduce the risk on the metabolic syndrome, which origin has to be found in early life, as stated on Barker’s hypothesis21,22,23. Morgan et al supports the concept that genetic factors associated with obesity and/ or risk of type 2 diabetes are more prevalent in those born SGA compared to those born appropriate for gestational age (AGA)24. Meas. et al stated that being born SGA affects body composition: Adults, born SGA, show an accelerated gain in BMI and waist circumference, which in turn results in higher body fat content with a central
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