To the Editor.

In January 2005, we submitted that high-dose growth hormone (GH) treatment (∼60 μg/kg per day for 6 months) raises the neutrophil count and that metformin treatment (425 mg/day for 6 months) lowers it in children born small for gestational age (SGA) with short stature or precocious pubarche. At the end of that report, we expressed the need to verify whether the GH-associated rise and the metformin-associated fall of the neutrophil count persist over time and whether they are specific for SGA children and/or for high-dose GH therapy.

Our own subsequent studies have since confirmed the hyperneutrophilia-lowering effect of metformin in adolescents with hyperinsulinemic hyperandrogenism and also in low birth weight girls with early-normal puberty. A high neutrophil count was also found to emerge by the age of 4 years in SGA children with spontaneous catch-up growth, in parallel with the development of insulin resistance....

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