Brabant G, Poll E M, Jönsson P, Polydorou D, Kreitschmann-Andermahr I
Department of Endocrinology, Christie Hospital, Manchester, UK.
Eur J Endocrinol. 2009 Nov;161 Suppl 1:S25-31. doi: 10.1530/EJE-09-0273. Epub 2009 Aug 14.
Previous work has examined potential links between the etiology of GH deficiency (GHD) and the baseline characteristics of the patients including biochemical and psychometric parameters. Using an update of the KIMS pharmaco-epidemiological database (Pfizer International Metabolic Database), we addressed the question how well such results can be generalized and whether regional differences may play a role. From 30 different countries, 13 167 GH-deficient patients were included in KIMS at the data close in December 2008. In order to explore country-specific differences of baseline characteristics documented in KIMS, separate analyses of baseline characteristics of adult-onset GHD patients (n=7708) were performed for the six largest contributing European countries and the United States. This analysis revealed striking regional variations in the pathogenesis of the disease, clinical characteristics such as body mass index, and in the classical features of the metabolic syndrome such as blood pressure or lipid status between countries. Moreover, the approach to endocrine function testing was widely different between countries, as well as the distribution of etiologies of GHD. These data suggest that a complex relation between biochemical and clinical signs of GHD exists, and that the spectrum of adult GHD syndrome is influenced by regional diagnostic and clinical particularities.
以往的研究探讨了生长激素缺乏症（GHD）的病因与患者基线特征（包括生化和心理测量参数）之间的潜在联系。我们利用辉瑞国际代谢数据库（KIMS）药物流行病学数据库的更新数据，研究了这些结果在多大程度上具有普遍性，以及地区差异是否可能发挥作用。截至2008年12月数据截止时，来自30个不同国家的13167例生长激素缺乏患者被纳入KIMS数据库。为了探究KIMS中记录的基线特征的国家特异性差异，我们对来自欧洲六个主要国家和美国的成年起病GHD患者（n = 7708）的基线特征进行了单独分析。该分析揭示了各国之间在疾病发病机制、体重指数等临床特征以及代谢综合征的经典特征（如血压或血脂状况）方面存在显著的地区差异。此外，各国在内分泌功能测试方法以及GHD病因分布方面也存在很大差异。这些数据表明，GHD的生化和临床体征之间存在复杂的关系，成人GHD综合征的范围受地区诊断和临床特殊性的影响。
