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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Se estima que entre un 3 y un 5&#37; de los reci&#233;n nacidos son peque&#241;os para la edad gestacional &#40;PEG&#41;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a>&#44; con un aumento progresivo de la incidencia en la &#250;ltima d&#233;cada<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a>&#46; El PEG est&#225; definido como aquel reci&#233;n nacido cuyo peso y&#47;o longitud se encuentra 2 desviaciones est&#225;ndar &#40;DE&#41; por debajo de la media establecida para su edad gestacional seg&#250;n los datos de la poblaci&#243;n de referencia<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Las causas que dan lugar a reci&#233;n nacidos PEG pueden agruparse en causas fetales&#44; maternas&#44; placentarias y ambientales&#44; aunque en un tercio de los casos no es posible determinar el origen de la restricci&#243;n del crecimiento fetal<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Los ni&#241;os PEG constituyen un grupo de mayor riesgo de alteraciones en la composici&#243;n corporal&#44; trastornos puberales&#44; retrasos en el desarrollo neurol&#243;gico&#44; as&#237; como en el desarrollo de un s&#237;ndrome metab&#243;lico&#44; con un aumento de factores de riesgo predictores de enfermedad cardiovascular&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Un 80-90&#37; de los ni&#241;os PEG efectuar&#225;n un crecimiento recuperador <span class="elsevierStyleItalic">&#40;catch-up growth&#41;</span> de forma espont&#225;nea&#44; normalizando su talla hacia los 2 a&#241;os de edad<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a>&#44; poni&#233;ndose en disposici&#243;n de alcanzar su potencial gen&#233;tico<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3-5</span></a>&#46; No obstante&#44; un 10-20&#37; de estos ni&#241;os no lo realizar&#225;n&#44; desconoci&#233;ndose la causa&#46; Despu&#233;s de los 4 a&#241;os la recuperaci&#243;n espont&#225;nea es muy poco probable<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; En este grupo de ni&#241;os se aprob&#243; el tratamiento con hormona de crecimiento &#40;rhGH&#41; por la <span class="elsevierStyleItalic">European Agency for the Evaluation of Medical Products</span> &#40;EMEA&#41; y la <span class="elsevierStyleItalic">Food and Drug Administration</span> &#40;FDA&#41; en 2003&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La rhGH produce un aumento de la velocidad de crecimiento que permite a estos ni&#241;os alcanzar una talla final adulta normal<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Adem&#225;s del efecto sobre el crecimiento lineal&#44; la rhGH es una hormona anab&#243;lica que modifica el metabolismo de las grasas e hidratos de carbono<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a>&#44; dando lugar a cambios en la composici&#243;n corporal<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo de nuestro trabajo ha sido analizar las modificaciones en las variables antropom&#233;tricas&#44; anal&#237;ticas de riesgo metab&#243;lico y de composici&#243;n corporal en un grupo de ni&#241;os PEG antes del inicio del tratamiento con rhGH y durante 4 a&#241;os de seguimiento&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o del estudio y participantes</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se trata de un estudio prospectivo longitudinal&#44; con una cohorte de 28 ni&#241;os nacidos en el Hospital Cl&#237;nico Universitario de Zaragoza entre los a&#241;os 1995 y 2009 con diagn&#243;stico de PEG&#46; La inclusi&#243;n de todos los pacientes ha sido consecutiva&#46; No existe grupo control&#46; Se ha realizado un seguimiento durante 4 a&#241;os donde se comparan los datos de la muestra a lo largo de este tiempo&#46; El seguimiento completo ha sido alcanzado por el 71&#37; de la muestra&#44; encontr&#225;ndose el 29&#37; restante en fases m&#225;s precoces del tratamiento al haber tenido lugar su inclusi&#243;n en la muestra m&#225;s tarde&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los pacientes incluidos cumpl&#237;an los criterios requeridos por el comit&#233; asesor para la rhGH del Ministerio de Sanidad&#44; Servicios Sociales e Igualdad para ni&#241;os PEG&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8211;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Longitud y&#47;o peso al nacer inferior a &#8211;2 DE de los est&#225;ndares de referencia<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a>&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8211;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Talla a partir de los 4 a&#241;os de edad inferior a &#8211;2&#44;5 DE por debajo de los est&#225;ndares de referencia<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a>&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8211;</span><p id="par0055" class="elsevierStylePara elsevierViewall">No haber tenido a los 4 a&#241;os de vida un crecimiento recuperador&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8211;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Haber sido descartado cualquier problema m&#233;dico o tratamiento como causa del trastorno de crecimiento&#46;</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">Los criterios de exclusi&#243;n han sido los siguientes&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8211;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Incumplimiento de criterios auxol&#243;gicos de inclusi&#243;n&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8211;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Ciertos cuadros sindr&#243;micos potencialmente no beneficiables&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8211;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Padecer diabetes mellitus u otros trastornos importantes del metabolismo de los hidratos de carbono&#46;</p></li></ul></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedimiento</span><p id="par0085" class="elsevierStylePara elsevierViewall">Se han recogido los datos neonatales de la muestra&#58; peso y longitud &#40;Z score&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> al nacer&#46; Edad gestacional &#40;semanas&#41;&#46; Se ha calculado la talla gen&#233;tica &#40;DE&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Se han estudiado las siguientes variables antes del inicio del tratamiento y en los 4 a&#241;os posteriores de seguimiento&#58;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Variables cl&#237;nicas y antropom&#233;tricas</span><p id="par0095" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8211;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Variables antropom&#233;tricas&#58; peso &#40;DE&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a>&#59; talla &#40;DE&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a>&#59; &#237;ndice de masa corporal en DE &#40;IMC&#41;&#44; y velocidad de crecimiento &#40;VC&#41; en DE&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8211;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Variables cl&#237;nicas&#58; presi&#243;n arterial sist&#243;lica y diast&#243;lica &#40;PAS&#44; PAD&#41;&#58; se ha determinado con un tensi&#243;metro autom&#225;tico realizando la elecci&#243;n de la anchura del manguito en funci&#243;n del per&#237;metro del brazo&#46; Se ha tomado en mmHg y en Z score seg&#250;n las gr&#225;ficas de referencia<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a>&#46; Per&#237;metro de cintura en cm &#40;P cintura&#41; y en Z score<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a>&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables anal&#237;ticas de riesgo metab&#243;lico</span><p id="par0110" class="elsevierStylePara elsevierViewall">Glucemia &#40;mg&#47;dl&#41;&#44; hemoglobina glucosilada en &#37; &#40;Hb glucosilada&#41;&#44; triglic&#233;ridos en mg&#47;dl &#40;TG&#41;&#44; cociente colesterol total&#47;HDL &#40;CL&#47;HDL&#41;&#44; IGF1&#40;ng&#47;ml&#41;&#44; IGF1BP3 &#40;mcg&#47;ml&#41;&#44; cociente IGF1&#47;IGF1BP3&#44; insulinemia &#40;mU&#47;ml&#41; y el &#237;ndice HOMA &#40;glucemia &#91;mg&#47;l&#93; &#215; insulinemia &#91;mU&#47;ml&#93;&#47;22&#44;5&#41;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">16&#44;17</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Variables de composici&#243;n corporal</span><p id="par0115" class="elsevierStylePara elsevierViewall">A todos los pacientes se les han realizado exploraciones anuales de composici&#243;n corporal con densit&#243;metro modelo HOLOGIC 2003-ExplorerTM&#44; obteni&#233;ndose datos de total de masa magra &#40;MM&#41;&#44; total de masa grasa &#40;MG&#41; y el porcentaje de masa magra y grasa&#46; Se ha calculado la proporci&#243;n de masa grasa y masa magra sobre el conjunto de ambas &#40;MG&#47;MG<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MM&#59; MM&#47;MG<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MM&#41;&#44; para valorar los cambios de composici&#243;n corporal a lo largo del tiempo&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis estad&#237;stico</span><p id="par0120" class="elsevierStylePara elsevierViewall">Para describir las caracter&#237;sticas basales de la muestra se ha realizado un estudio descriptivo de las variables cuantitativas &#40;media&#44; desviaci&#243;n est&#225;ndar&#44; m&#237;nimo&#44; m&#225;ximo&#44; mediana y rango intercuartil&#41;&#44; as&#237; como un m&#233;todo de distribuci&#243;n de frecuencias para variables cualitativas&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Para efectuar los contrastes de hip&#243;tesis se han utilizado t&#233;cnicas param&#233;tricas&#44; ya que se cumplen los criterios de normalidad de Kolmogorov-Smirnov y Shapiro-Wilk&#44; y de homocedasticidad de Levene&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Para describir las variaciones a lo largo de los a&#241;os de seguimiento se ha utilizado la prueba de contraste de medias de ANOVA para datos pareados&#46; En los casos en los que ANOVA arrojaba diferencias significativas se ha aplicado la prueba t de Student para analizar por rangos y poder determinar en qu&#233; momento se producen las diferencias encontradas&#46; Para realizar el contrate de hip&#243;tesis seg&#250;n el sexo se ha utilizado la prueba t de Student para 2 muestras independientes&#46; Se han considerado estad&#237;sticamente significativos valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico de los datos se ha realizado con el programa SPSS 20&#46;0 para Windows&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">El estudio ha sido aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica en Arag&#243;n &#40;CEICA&#41; adscrito al departamento de Salud y Consumo del Gobierno de Arag&#243;n&#46; Adem&#225;s se recogi&#243; el consentimiento informado de los pacientes y familiares&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Caracter&#237;sticas basales</span><p id="par0145" class="elsevierStylePara elsevierViewall">La muestra est&#225; compuesta por 28 sujetos&#58; 21 mujeres &#40;75&#37;&#41; y 7 varones &#40;25&#37;&#41;&#46; El 78&#44;5&#37; de la muestra estaba al inicio del estudio en Tanner I&#44; y el 21&#44;5&#37; en Tanner II&#46; El cociente entre la edad &#243;sea y la edad cronol&#243;gica es de 0&#44;70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;522&#46; La dosis media de rhGH administrada ha sido 0&#44;029<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#237;a&#46;<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8211;</span><p id="par0150" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Al nacimiento</span>&#58; la media de edad gestacional fue de 38&#44;29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;46 semanas&#44; con unos datos auxol&#243;gicos medios de 46&#44;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;39<span class="elsevierStyleHsp" style=""></span>cm de longitud &#40;&#8211;2&#44;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;20 DE&#41; y 2&#46;575<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>85&#44;63<span class="elsevierStyleHsp" style=""></span>g de peso &#40;&#8211;1&#44;38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;23 DE&#41;&#46; La media de la talla gen&#233;tica fue de &#8211;1&#44;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;12 DE&#46; No se encontraron diferencias significativas con respecto al sexo en ninguna de estas variables&#46; Entre las causas recogidas en los datos gestacionales que pudiesen contribuir al crecimiento intrauterino restringido podemos destacar con un 35&#44;7&#37; causas ambientales &#40;tabaco y trabajo materno&#41;&#44; 10&#44;7&#37; causas maternas&#44; 10&#44;7&#37; causas fetales y 7&#44;1&#37; causas placentarias&#44; mientras que en un 35&#44;7&#37; se consider&#243; idiop&#225;tico&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8211;</span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Al inicio del tratamiento</span>&#58; los datos antropom&#233;tricos&#44; anal&#237;ticos y de composici&#243;n corporal aparecen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La edad media de inicio fue de 8&#44;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;06 a&#241;os&#46; La talla media es de &#8211;2&#44;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;45 DE&#44; con una velocidad de crecimiento &#8211;1&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;79 DE&#46; Los datos cl&#237;nicos de PA y per&#237;metro de cintura se encuentran en el rango de normalidad&#44; al igual que los datos anal&#237;ticos pretratamiento&#46; Destacan &#250;nicamente unas mayores cifras de insulinemia e &#237;ndice HOMA en mujeres&#44; sin llegar a alcanzar niveles de resistencia insul&#237;nica &#40;insulinemia varones&#58; 5&#44;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;42 vs&#46; mujeres&#58; 10&#44;59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;01&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042 &#47; &#237;ndice HOMA varones&#58; 1&#44;89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;98 vs&#46; mujeres&#58; 4&#44;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;32&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se puede observar c&#243;mo estas 2 variables mencionadas muestran diferencias significativas al analizarlas seg&#250;n el estadio puberal &#40;insulinemia prepuberal 6&#44;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;98<span class="elsevierStyleHsp" style=""></span>mU&#47;ml vs&#46; insulinemia puberal de 19&#44;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;41<span class="elsevierStyleHsp" style=""></span>mU&#47;ml&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#44; y un &#237;ndice HOMA prepuberal 2&#44;54<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;09 vs&#46; HOMA puberal de 7&#44;32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;42&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li></ul></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Evoluci&#243;n de los datos antropom&#233;tricos&#44; cl&#237;nicos y anal&#237;ticos durante 4 a&#241;os de tratamiento</span><p id="par0160" class="elsevierStylePara elsevierViewall">La evoluci&#243;n de los datos podemos observarla en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Datos antropom&#233;tricos</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#58; la talla present&#243; un incremento paulatino a lo largo de los a&#241;os &#40;&#8211;2&#44;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;45 DE hasta &#8211;1&#44;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;62 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41;&#44; encontrando diferencias significativas en todos los a&#241;os estudiados&#46; En la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> se puede observar c&#243;mo la talla se va acercando a la talla gen&#233;tica&#44; y c&#243;mo la m&#225;xima ganancia de talla se produce en el primer a&#241;o de tratamiento&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0170" class="elsevierStylePara elsevierViewall">El peso mejor&#243; a lo largo de los a&#241;os &#40;&#8211;1&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;50 DE hasta &#8211;1&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;49 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#46; La velocidad de crecimiento fue aumentando progresivamente &#40;&#8211;1&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;79 DE hasta 0&#44;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;52 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#46; No se evidenciaron diferencias con respecto al &#237;ndice de masa corporal&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">No hubo diferencias con respecto al sexo en ninguna variable&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Datos cl&#237;nicos&#58;</span> no se han visto cambios en la presi&#243;n arterial sist&#243;lica a lo largo del tiempo&#44; aunque s&#237; que aparecen cambios significativos de la presi&#243;n arterial diast&#243;lica&#44; que disminuye en el segundo a&#241;o de tratamiento &#40;&#8211;0&#44;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;13 DE vs&#46; &#8211;0&#44;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;13 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#46; No hay cambios en el per&#237;metro de cintura&#46; No hay cambios en las variables con respecto al sexo&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Datos anal&#237;ticos</span>&#58; la hemoglobina glucosilada aumenta de forma significativa&#44; aunque manteni&#233;ndose en rango normal&#44; con unas cifras al inicio de 5&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;49&#37;&#44; y al cuarto a&#241;o de 5&#44;30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;30&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; El incremento m&#225;s marcado se produce en el primer a&#241;o de tratamiento&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Las cifras de insulinemia aumentan de forma significativa a lo largo de los a&#241;os&#59; los valores al inicio son de 9&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;26<span class="elsevierStyleHsp" style=""></span>mU&#47;ml&#44; y al cuarto a&#241;o son de 16&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;22<span class="elsevierStyleHsp" style=""></span>mU&#47;ml &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#41;&#44; con cifras dentro de rangos normales&#46; No se observan en el seguimiento discrepancias con respecto al sexo&#44; como se observaban en los valores basales&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Los valores de IGF1&#44; IGF1BP3&#44; as&#237; como su cociente&#44; aumentan de forma significativa&#44; siendo el primer y el segundo a&#241;o los que dan lugar a estos aumentos&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">El &#237;ndice HOMA aumenta significativamente desde 3&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;42 hasta 6&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;55 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41; probablemente a expensas del aumento de la insulinemia&#44; ya que no se observan cambios en la glucemia basal&#46; No aparecen diferencias en el perfil lip&#237;dico a lo largo de los a&#241;os&#46; No se encuentran diferencias con respecto al sexo en ninguna de las variables analizadas&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Datos de composici&#243;n corporal</span>&#58; la masa magra aumenta de forma significativa a lo largo del seguimiento &#40;16&#46;303<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;686&#44;05<span class="elsevierStyleHsp" style=""></span>g hasta 31&#46;153&#44;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;214&#44;24<span class="elsevierStyleHsp" style=""></span>g&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41;&#46; La masa grasa experimenta un aumento progresivo debido al crecimiento de los pacientes&#44; pero no muestra cambios significativos&#46; Adem&#225;s se observa un aumento significativo del porcentaje de masa magra a expensas de las modificaciones que se dan en el primer a&#241;o de tratamiento &#40;70&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;09&#37; hasta 74&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;62&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0034&#41;&#44; as&#237; como una disminuci&#243;n del porcentaje de masa grasa &#40;25&#44;94<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;09&#37; hasta 21&#44;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;81&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;015&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">El cociente MM&#47;MM<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MG se incrementa a lo largo del seguimiento desde 73&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;90 hasta 78&#44;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;33 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#44; siendo este aumento m&#225;s marcado en varones&#46; Al ser su complementario&#44; el cociente MG&#47;MM<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MG disminuye&#46; Al analizar por rangos&#44; las diferencias estad&#237;sticas se obtienen por las modificaciones ocurridas en el primer a&#241;o de tratamiento&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0215" class="elsevierStylePara elsevierViewall">Los PEG son un grupo de riesgo para el desarrollo de m&#250;ltiples enfermedades en la edad adulta<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a>&#46; La mayor parte de estos ni&#241;os realiza un crecimiento recuperador para alcanzar su potencial gen&#233;tico antes de los 4 a&#241;os de edad&#46; Sin embargo&#44; en este grupo de pacientes&#44; debido a un metabolismo ahorrador&#44; se producen cambios en la composici&#243;n corporal&#44; con un aumento en el IMC<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> a expensas de un aumento de la grasa central&#44; con dep&#243;sito intraabdominal<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#44;21</span></a>&#46; Esto determina una serie de alteraciones&#44; como una insulinorresistencia&#44; que predisponen a padecer otras enfermedades en la vida adulta<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a>&#44; tales como enfermedad cardiovascular&#44; diabetes o s&#237;ndrome metab&#243;lico<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a>&#46; Se ha demostrado que tienen m&#225;s riesgo los pacientes con un crecimiento espont&#225;neo r&#225;pido que los tratados con rhGH<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">24-26</span></a>&#46; Soto et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">26</span></a> describen una resistencia a la insulina en ni&#241;os nacidos PEG con crecimiento recuperador que no presentan los que no lo experimentan&#44; por lo que sugieren que es muy importante el efecto que tiene un r&#225;pido <span class="elsevierStyleItalic">catch-up</span> en las alteraciones metab&#243;licas&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Los pacientes incluidos en nuestro estudio eran candidatos a tratamiento con rhGH al no haber realizado el crecimiento recuperador&#46; Antes de empezar el tratamiento se objetiv&#243; que las variables anal&#237;ticas metab&#243;licas se encontraban dentro de rangos normales&#46; Es importante recalcar que se han encontrado diferencias en las variables de insulinemia y del &#237;ndice HOMA pretratamiento al analizar por grupos seg&#250;n su estadio puberal&#44; siendo los pacientes puberales los que presentaban mayores valores&#46; Las diferencias encontradas con respecto al sexo pueden estar influenciadas por la mayor presencia de pacientes femeninos en estadio puberal&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">En este estudio&#44; el an&#225;lisis de las variables antropom&#233;tricas a lo largo de los a&#241;os de tratamiento revela un incremento significativo de la velocidad de crecimiento&#44; m&#225;s marcado en el primer a&#241;o&#44; que determina un aumento de la talla final&#44; la cual se aproxima a la potencial talla gen&#233;tica de los pacientes&#46; Tambi&#233;n se observa una normalizaci&#243;n del peso corporal&#44; que al principio del seguimiento se encontraba en el l&#237;mite bajo de la normalidad&#46; Estos hallazgos concuerdan con lo descrito en la bibliograf&#237;a<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;10</span></a>&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Hemos objetivado tambi&#233;n un aumento progresivo&#44; aunque manteni&#233;ndose en rango de normalidad&#44; en las cifras de insulinemia&#44; hemoglobina glucosilada y del &#237;ndice HOMA&#44; que indican cierta tendencia a la resistencia insul&#237;nica&#46; Esto ya ha sido descrito por Lebl et al&#46;&#44; que demuestran tambi&#233;n una normalizaci&#243;n de estas variables tras suspender el tratamiento<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">27</span></a>&#46; Es importante continuar el seguimiento de estos pacientes para valorar la transcendencia de estos aumentos encontrados en el metabolismo hidrocarbonado&#44; y ver si se mantienen en el tiempo o son reversibles al finalizar el tratamiento&#44; como ya se ha descrito&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Es conocida la respuesta dosis-dependiente de GH sobre el aumento de IGF1 e IGFBP3<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a>&#46; Los niveles de ambos aumentaron a lo largo de todo el seguimiento&#44; siendo mayor el incremento de IGF1&#44; que determina un aumento del cociente IGF1&#47;IGF1BP3&#46; Durante el seguimiento las cifras han estado dentro de rangos de normalidad&#46; No existe un claro consenso internacional sobre cu&#225;les son los l&#237;mites altos de la normalidad&#44; con la consiguiente preocupaci&#243;n de los posibles efectos que pueden tener unas cifras altas mantenidas en el tiempo<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">No hemos encontrado cambios significativos en la presi&#243;n arterial sist&#243;lica&#44; en el IMC&#44; en el per&#237;metro de cintura&#44; ni en el metabolismo lip&#237;dico&#46; S&#237; que hemos observado un descenso en la presi&#243;n arterial diast&#243;lica&#46; Ya ha sido descrito que el tratamiento con rhGH es efectivo para normalizar las cifras tensionales&#44; tanto sist&#243;licas como diast&#243;licas&#44; en pacientes previamente hipertensos<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">30&#44;31</span></a>&#44; lo que puede contribuir a disminuir el riesgo cardiovascular inherente a los PEG&#46; En nuestro caso&#44; los pacientes presentaban al inicio cifras tensionales normales&#44; raz&#243;n por la que podr&#237;an no haberse visto grandes cambios&#46; Algo similar nos ocurre en relaci&#243;n con el perfil lip&#237;dico&#44; que en otros estudios mejora desde el primer a&#241;o de tratamiento<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">30</span></a>&#46; En nuestro caso&#44; las cifras basales eran ya normales&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">La composici&#243;n corporal de los ni&#241;os PEG es diferente a la de los adecuados para la edad gestacional&#58; tienen una menor grasa corporal total&#44; menor masa magra y menor contenido mineral &#243;seo<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a>&#46; Su proporci&#243;n masa grasa&#47;masa magra est&#225; aumentada&#44; siendo este un factor de riesgo para desarrollar s&#237;ndrome metab&#243;lico&#46; El punto fuerte de nuestro estudio radica en los cambios que se evidencian al analizar la composici&#243;n corporal de los pacientes&#46; Se puede observar&#44; seg&#250;n la variaci&#243;n de los cocientes estudiados&#44; c&#243;mo se produce un aumento significativo de la proporci&#243;n de masa magra con respecto a la masa grasa a lo largo del tiempo&#44; m&#225;s evidente en los varones y durante el primer a&#241;o de tratamiento&#46; Las modificaciones descritas podr&#237;an determinar una disminuci&#243;n del riesgo metab&#243;lico inherente a los PEG&#44; pudiendo por ello reducir la incidencia de problemas cardiovasculares en este grupo de pacientes una vez alcanzada la edad adulta&#46; Este hecho refuerza la importancia del tratamiento con rhGH en ni&#241;os PEG&#44; m&#225;s all&#225; del objetivo principal&#44; que es aumentar la talla&#46; Resulta por todo ello fundamental continuar el seguimiento de estos ni&#241;os&#44; para valorar la evoluci&#243;n de estas variables con el paso del tiempo&#44; una vez finalizado el tratamiento con rhGH&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusi&#243;n</span><p id="par0250" class="elsevierStylePara elsevierViewall">El tratamiento con rhGH en un grupo de ni&#241;os PEG sin crecimiento recuperador ha sido efectivo al observarse una clara ganancia de talla&#44; con normalizaci&#243;n del peso y sin alterar el &#237;ndice de masa corporal&#46; Se han dado cambios importantes en la composici&#243;n corporal&#44; con un aumento de la masa magra a expensas de una disminuci&#243;n de la masa grasa&#46; Adem&#225;s se ha descrito una cierta afectaci&#243;n del metabolismo hidrocarbonado&#44; con datos de resistencia insul&#237;nica&#46; No ha habido modificaciones en el perfil lip&#237;dico&#46; Estos hechos requieren continuar el seguimiento hasta que la muestra alcance la talla adulta&#44; para estudiar si se mantienen en el tiempo y sus consecuencias a largo plazo&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicto de intereses</span><p id="par0255" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los ni&#241;os peque&#241;os para la edad gestacional &#40;PEG&#41; sin crecimiento recuperador pueden beneficiarse del tratamiento con hormona de crecimiento &#40;rhGH&#41;&#46; Sin embargo&#44; deben ser monitorizados de forma muy estrecha ya que son poblaci&#243;n de riesgo metab&#243;lico&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se han incluido 28 ni&#241;os PEG&#44; con una media de edad de 8&#44;79 a&#241;os&#44; sin crecimiento recuperador&#44; tratados con rhGH&#46; Hemos evaluado las modificaciones producidas en la antropometr&#237;a&#44; variables de riesgo metab&#243;lico y composici&#243;n corporal durante 4 a&#241;os de tratamiento&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El tratamiento con rhGH se acompa&#241;&#243; de un aumento de talla &#40;&#8211;2&#44;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;11 DE hasta &#8211;1&#44;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;17 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41;&#44; peso &#40;&#8211;1&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;09 DE hasta &#8211;1&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;13 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41; y velocidad de crecimiento &#40;&#8211;1&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;35 DE hasta 0&#44;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;41 DE&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#44; sin producir modificaciones en el &#237;ndice de masa corporal &#40;IMC&#41;&#46; Se han visto aumentos significativos de la insulinemia &#40;9&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;93<span class="elsevierStyleHsp" style=""></span>mU&#47;ml hasta 16&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;72<span class="elsevierStyleHsp" style=""></span>mU&#47;ml&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#41; y del &#237;ndice HOMA &#40;3&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;76 hasta 6&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;67&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41;&#44; sin producirse modificaciones en el perfil lip&#237;dico&#46; En el estudio de composici&#243;n corporal se ha comprobado un aumento significativo de la masa magra &#40;73&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;26 hasta 78&#44;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;31&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41; con una disminuci&#243;n de la masa grasa &#40;26&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;26 hasta 21&#44;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;31&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El tratamiento con rhGH se ha acompa&#241;ado de una ganancia en la talla sin producir alteraciones en el IMC&#46; Asimismo&#44; se han observado cambios en la composici&#243;n corporal&#44; con un aumento de la proporci&#243;n de masa magra a expensas de una disminuci&#243;n de la de masa grasa&#44; que podr&#237;an conducir a un descenso del riesgo metab&#243;lico de estos pacientes&#46; Sin embargo&#44; se ha detectado cierta resistencia insul&#237;nica&#46; Es importante continuar el seguimiento de estos ni&#241;os para determinar las posibles repercusiones en la edad adulta&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction and objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Small for gestational age &#40;SGA&#41; children without catch-up growth can benefit from treatment with growth hormone &#40;rhGH&#41;&#46; However&#44; they should be monitored very closely because they are at increased risk of metabolic syndrome&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A group of 28 SGA children with a mean age of 8&#46;79 years and undergoing treatment with rhGH were selected for evaluation&#46; Over the course of 4 years&#44; an annual evaluation was performed on the anthropometric variables &#40;weight&#44; height&#44; body mass index &#91;BMI&#93;&#44; growth rate&#44; blood pressure and waist perimeter&#41;&#44; metabolic risk variables &#40;glycaemia&#44; glycosylated haemoglobin&#44; cholesterol ratio&#44; insulinaemia&#44; insulin-like growth factor 1&#91;IGF1&#93;&#44; IGF binding protein-3 &#91;IGFBP-3&#93;&#44; IGF1&#47;IGFBP3 ratio&#44; and HOMA index&#41;&#44; and body composition variables&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Treatment with rhGH was associated with a significant increase in height &#40;&#8211;2&#46;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;11 SD to &#8211;1&#46;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;17 SD&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;000&#41;&#44; weight &#40;&#8211;1&#46;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;09 SD to &#8211;1&#46;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;13 SD&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;016&#41;&#44; and growth rate &#40;&#8211;1&#46;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;35 SD to &#46;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;41 SD&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009&#41;&#44; without a corresponding change in the BMI&#46; Insulinaemia &#40;9&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;93<span class="elsevierStyleHsp" style=""></span>mU&#47;ml to 16&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;72<span class="elsevierStyleHsp" style=""></span>mU&#47;ml&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;044&#41; and the HOMA index &#40;3&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;76 to 6&#46;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>&#46;67&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;042&#41; increased&#44; approaching insulin resistance levels&#46; No changes were observed in the lipid profile&#46; Body composition changes were observed&#44; with a significant increase in lean mass &#40;73&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;26 to 78&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;31&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;037&#41;&#44; and a reduction of fat mass &#40;26&#46;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;26 to 21&#46;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;31&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;021&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Treatment with rhGH is effective for improving anthropometric variables in SGA patients who have not experienced a catch-up growth&#46; It also produces changes in body composition&#44; which may lead to a reduction in risk of metabolic syndrome&#46; However&#44; some insulin resistance was observed&#46; It is important to follow up this patient group in order to find out whether these changes persist into adulthood&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction and objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material and method"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusion"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Este art&#237;culo fue presentado mediante comunicaci&#243;n libre en formato p&#243;ster en el Congreso Extraordinario de la AEP y II Congreso Extraordinario Latinoamericano de Pediatr&#237;a&#44; celebrado en Madrid del 5 al 7 de junio del 2014&#44; siendo galardonado con el premio de menci&#243;n especial al mejor p&#243;ster de dicho congreso&#46;</p>"
      ]
    ]
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evoluci&#243;n de los datos antropom&#233;tricos a lo largo del tratamiento con hormona de crecimiento&#46;</p>"
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        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Evoluci&#243;n de la talla &#40;DE&#41; en relaci&#243;n con su talla gen&#233;tica &#40;DE&#41; a lo largo del seguimiento&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Datos disponibles para 28 pacientes&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; DEXA&#58; composici&#243;n corporal&#59; IMC&#58; &#237;ndice de masa corporal&#59; MG&#58; masa grasa total&#59; MM&#58; masa magra total&#59; ns&#58; no significativo&#59; P cintura&#58; per&#237;metro de cintura&#59; PAD&#58; presi&#243;n arterial diast&#243;lica&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; VC&#58; velocidad de crecimiento&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;1&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;2&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Datos cl&#237;nicos</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PAS &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;022<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PAS &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;20<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;1&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;010<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PAD &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PAD &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;1&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>P&#46; cintura &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>P&#46; cintura &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;2&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;1&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Datos anal&#237;ticos</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Glucemia &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hb glucosilada &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;01 &#177;0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Triglic&#233;ridos &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#44;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Colesterol total&#47;HDL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;72<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insulinemia &#40;mU&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;33 &#177;11&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;042<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGF1 &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">232&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>166&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">601&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">340&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGF1BP3 &#40;mcg&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGF1&#47;IGF1BP3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#205;ndice HOMA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">DEXA</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa grasa &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;214&#44;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;540&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;581&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;832&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;418&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;508&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;327&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa grasa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa magra &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#46;080&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;589&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;602&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#46;575&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa magra &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>MG&#47;MG<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;00<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>P cintura &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#44;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#44;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#44;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;860&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="char" valign="top"><span class="elsevierStyleItalic">Datos anal&#237;ticos</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Glucemia&#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#44;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;542&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hb glicosilada&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;01 &#177;0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>TG&#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#44;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#44;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>38&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Colesterol&#47;HDL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;859&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insulina &#40;mU&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;044<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGF1 &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">232&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>166&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">358&#44;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>173&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">463&#44;08&#177; 196&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">518&#44;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>184&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">574&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>156&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGFBP3&#40;mcg&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;05<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;31<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IGF1&#47;IGF1BP3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81&#44;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#205;ndice HOMA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;042<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="char" valign="top"><span class="elsevierStyleItalic">DEXA</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa grasa &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;214&#44;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;540&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;439&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;975&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;664&#44;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;582&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;121&#44;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;905&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;346&#44;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;293&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masa grasa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#44;94<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;91<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;39&nbsp;\t\t\t\t\t\t\n
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