Boonstra Venje H, Mulder Paul G H, de Jong Frank H, Hokken-Koelega Anita C S
Department of Pediatrics, Division of Endocrinology, Sophia Children's Hospital, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 2004 Feb;89(2):712-7. doi: 10.1210/jc.2003-031160.
It has been suggested that the programming of the endocrine axes occurs during critical phases of fetal development and will be affected by intrauterine growth retardation. As a result, children born small for gestational age (SGA) might have several hormonal disturbances. In later life, one of the questions that might arise is: Do short children born SGA have higher serum dehydroepiandrosterone sulfate (DHEAS) levels than their peers? Therefore, we compared serum DHEAS levels of 181 short prepubertal children aged 3-9 yr born SGA [birth length (SD score) below -2 for gestational age] with a control group of 170 prepubertal age-matched, normal-statured children born appropriate for gestational age (birth length between -2 and +2 SD score). Because relatively high serum DHEAS levels at a young age might result in a premature pubarche, we investigated the incidence of premature pubarche. We also investigated the association between serum DHEAS levels and bone maturation. In addition, we analyzed whether 1 yr of GH treatment with 1 and 2 mg/m(2).d ( approximately 0.035 and 0.070 mg/kg.d, respectively) had an effect on serum DHEAS levels of prepubertal short SGA children. Serum DHEAS levels of the SGA group were comparable with those of age-matched appropriate for gestational age controls. The incidence of premature pubarche was comparable with that of the normal population. There was a weak negative correlation between serum DHEAS levels and bone maturation after the age of 7 yr. After 1 yr of GH treatment, the increase of serum DHEAS levels was the same for both GH dosage groups and the untreated group. In conclusion, this study shows that small size at birth, which might be a feature of fetal growth restriction, has no effect on serum DHEAS levels before the age of 9 yr. The incidence of premature pubarche is comparable with the normal population. Finally, 1 yr of GH treatment has no effect on serum DHEAS levels.
有人提出，内分泌轴的编程发生在胎儿发育的关键阶段，并会受到宫内生长迟缓的影响。因此，小于胎龄儿（SGA）出生的儿童可能会出现多种激素紊乱。在其日后的生活中，可能会出现的一个问题是：SGA出生的矮小儿童的血清硫酸脱氢表雄酮（DHEAS）水平是否高于同龄人？因此，我们比较了181名3 - 9岁青春期前SGA出生的矮小儿童（出生身长低于胎龄的标准差评分-2）与170名年龄匹配、身高正常的青春期前适于胎龄儿（出生身长标准差评分在-2至+2之间）对照组的血清DHEAS水平。由于年轻时相对较高的血清DHEAS水平可能导致青春期过早出现，我们调查了青春期过早出现的发生率。我们还研究了血清DHEAS水平与骨骼成熟之间的关联。此外，我们分析了以1和2 mg/m²·d（分别约为0.035和0.070 mg/kg·d）进行1年的生长激素（GH）治疗是否对青春期前矮小SGA儿童的血清DHEAS水平有影响。SGA组的血清DHEAS水平与年龄匹配的适于胎龄儿对照组相当。青春期过早出现的发生率与正常人群相当。7岁以后，血清DHEAS水平与骨骼成熟之间存在弱负相关。经过1年的GH治疗，两个GH剂量组和未治疗组的血清DHEAS水平升高情况相同。总之，本研究表明，出生时身材矮小这一可能是胎儿生长受限的特征，在9岁之前对血清DHEAS水平没有影响。青春期过早出现的发生率与正常人群相当。最后，1年的GH治疗对血清DHEAS水平没有影响。
