Gawlik A, Gawlik T, Augustyn M, Woska W, Malecka-Tendera E
Department of Paediatrics, Paediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland.
Int J Clin Pract. 2006 Feb;60(2):150-5. doi: 10.1111/j.1742-1241.2005.00633.x.
Growth charts, which describe the natural course of growth in Turner syndrome (TS) patients, are commonly used in studies in lieu of control groups. While analysing data, various charts produce different final height estimations and height-gain predictions. The choice of an appropriate chart should be the first task when assessing effects of growth hormone treatment. The purpose of this study was to establish the most appropriate growth chart for the subsequent analysis of growth rate in the patients with TS observed initially for a short time without treatment in our clinic. We propose the criteria that a standardised chart should meet. The obtained height-standardised values (height standard deviation score -- Ht SDS) should represent normal distribution with a mean of 0 and standard deviation of 1; their initial mean value and mean change in these values during observation without treatment should not be different from 0. We studied 62 untreated girls with TS using three different growth charts. The values of Ht SDS based on the Lyon chart showed a significant difference from normal distribution (p < 0.05). Only the mean value of an initiaent from 0 (p = 0.088). The mean change of the Ht SDS value based on Lyon and Ranke charts during the follow-up period was not statistically different from 0 (p > 0.05), whereas the difference was statistically significant when the Wisniewski chart was used. Only the Ranke chart correctly characterised TS girls in our clinic. This analysis indicates the importance of careful selection of an appropriate growth chart for an observed population, before applying it to evaluate the effects of hormonal therapy.
生长曲线描述了特纳综合征（TS）患者的自然生长过程，在研究中常用于替代对照组。在分析数据时，不同的生长曲线会得出不同的最终身高估计值和身高增长预测值。在评估生长激素治疗效果时，选择合适的生长曲线应是首要任务。本研究的目的是确定最适合的生长曲线，用于后续分析我院最初短期未接受治疗的TS患者的生长速率。我们提出了标准化生长曲线应满足的标准。获得的身高标准化值（身高标准差评分——Ht SDS）应呈正态分布，均值为0，标准差为1；其初始均值以及在未治疗观察期间这些值的平均变化不应与0有差异。我们使用三种不同的生长曲线对62名未接受治疗的TS女孩进行了研究。基于里昂生长曲线的Ht SDS值与正态分布有显著差异（p < 0.05）。只有基于坦纳生长曲线的初始均值与0没有显著差异（p = 0.088）。随访期间基于里昂生长曲线和兰克生长曲线的Ht SDS值的平均变化与0没有统计学差异（p > 0.05），而使用维斯涅夫斯基生长曲线时差异具有统计学意义。在我院只有兰克生长曲线能正确地对TS女孩进行特征描述。该分析表明，在应用生长曲线评估激素治疗效果之前，为观察人群仔细选择合适的生长曲线非常重要。
