Cerebrovascular Abnormalities in Adults Born SGA at 12 Years After Growth Hormone Cessation Compared to Controls

Author:

Dorrepaal Demi Justine1ORCID,Goedegebuure Wesley Jim1,Smagge Lucas2,van der Steen Manouk1,van der Lugt Aad2,Hokken-Koelega Anita Charlotte Suzanne1

Affiliation:

1. Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital , 3015 CN Rotterdam , The Netherlands

2. Department of Radiology, Erasmus Medical Center , 3015 CN Rotterdam , The Netherlands

Abstract

Abstract Context Increased cerebrovascular morbidity was reported in adults born small for gestational age (SGA) who were treated with growth hormone (GH) during childhood compared to the general population. However, previous studies did not have an appropriate control group, which is a major limitation. Objective To study cerebrovascular abnormalities (aneurysms, previous intracerebral hemorrhages and microbleeds) using magnetic resonance imaging (MRI) in adults born SGA at 12 years after cessation of childhood GH treatment (SGA-GH) compared to appropriate controls. Methods In this single-center, prospective study, brain MRIs were performed between May 2016 and December 2020 on a 3T MRI system. MRI images were scored by 2 neuroradiologists who were blinded to patient groupings. Participants included adults born SGA previously treated with GH and 3 untreated control groups: adults born SGA with persistent short stature (SGA-S), adults born SGA with spontaneous catch-up growth to a normal height (SGA-CU) and adults born appropriate for gestational age with a normal height (AGA). The intervention was long-term GH treatment during childhood and the main outcome measure was cerebrovascular abnormalities. Results A total of 301 adults were investigated. Aneurysms were found in 6 adults: 3 (3.6%) SGA-GH, 1 (2.9%) SGA-S and 2 (2.2%) AGA adults, without differences between SGA-GH adults and the controls. Previous intracerebral hemorrhages were only found in 2 SGA-S adults (4.8%). Microbleeds were found in 17 adults: 4 (4.3%) SGA-GH, 4 (9.5%) SGA-S, 3 (4.3%) SGA-CU and 6 (6.3%) AGA adults, without differences between SGA-GH adults and the controls. Conclusion Our findings suggest that SGA-GH adults at 12 years after GH cessation have no increased prevalence of cerebrovascular abnormalities compared to appropriate controls. Further research is needed to confirm our findings.

Funder

Novo Nordisk Netherlands

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

Reference32 articles.

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2. Small for gestational age children without early catch-up growth: spontaneous growth and prediction of height at 8 years;De Ridder;Horm Res Paediatr,2008

3. Growth hormone treatment in children with short stature born small for gestational age: 5-year results of a randomized, double-blind, dose-response trial;Sas;J Clin Endocrinol Metab,1999

4. Adult height after long-term, continuous growth hormone (GH) treatment in short children born small for gestational age: results of a randomized, double-blind, dose-response GH trial;Van Pareren;J Clin Endocrinol Metab,2003

5. Final height in short children born small for gestational age treated with growth hormone;Dahlgren;Pediatr Res,2005

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