![]() From the four trials, the overall mean height gain was 1.5 SDS in GH treated versus 0.25 SDS in untreated SGA children, similar to our results. A meta-analysis identified four randomized controlled trials on near adult height in short children with SGA who received GH treatment. Several studies have reported that GH treatment in SGA children without catch-up growth increased height velocity and improves adult height. In our study, the mean height gain was 1.42 SDS for 3 years of GH treatment in short children born SGA. We also developed the prediction model that can be used to predict the first year response to GH treatment in prepubertal children with SGA. This analysis of data from the LGS demonstrated that GH treatment improved growth outcomes for children with SGA during the follow-up period. Prepubertal status was defined as absence of breast development in girls and testicular volume < 4 mL in boys. Pubertal maturation was determined following the Tanner and Marshall criteria. Bone age was estimated using the Greulich-Pyle method. To calculate SDS of height, weight, and BMI, we used LMS parameters (Lambda for the skew, Mu for the median, and Sigma) in the 2017 Korean National Growth Charts. Body mass index (BMI) was calculated using height and weight. Target height (TH) was calculated by adding 6.5 cm in boys or subtracting 6.5 cm in girls from mid-parental height. All laboratory analyses were performed according to local standard procedures of each site (total 73 sites). IGF-1 and IGFBP-3 SDS were calculated using Korean normal IGF-1 and IGFBP-3 levels for age and sex. If serum blood glucose was abnormal, oral glucose tolerance test or HbA1c were performed. Patients’ height, weight, bone age, gestational age, birth weight, insulin-like growth factor (IGF)-1, IGF-binding protein-3 (IGFBP-3), pubertal status, serum glucose, and thyroid function were collected from medical records at the time of evaluation and every 6 months. GH dose was adjusted based on weight at visits. GH was administered subcutaneously at a dose of 33–66 ug/kg/d (initial mean dose: 41.4 ± 1.1 ug/kg/d) for 6 days per week in patients with SGA. Therefore, the aim of this study was to evaluate the long-term effectiveness of GH treatment in short children born SGA and developed a model to predict individual responsiveness to GH treatment. Although many studies have found that GH treatment is an effective treatment for individuals with SGA who do not experience catch-up growth, there has been no large cohort study of the effectiveness of GH in Korean children born SGA. Growth hormone treatment has become much more frequent for SGA children with short stature after the approval of medical insurance in Korea. Since 2014, GH treatment has been covered by medical insurance for short children born SGA older than 4 years of age in Korea. ![]() ![]() This treatment was approved by the US Food and Drug Administration in 2001 and by the European Medicines Agency. Several recent studies have shown that growth hormone (GH) treatment is effective to improve adult height in children born SGA without catch-up growth. However, approximately 10% of children fail to demonstrate catch-up growth, and they remain small throughout childhood and adolescence. Ninety percent of children born SGA eventually show catch-up growth regardless of predisposing factors during the first 2 years of life. Being born SGA is associated with increased risk of insulin resistance, type 2 diabetes mellitus, lower intelligence, cardiovascular disease, neurodevelopmental impairments, and adult short stature, compared with individuals born appropriate for gestational age. Small for gestational age (SGA) is a clinical entity defined as newborn infants whose weight and/or length is below the normal for their gestational age and sex.
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