Van Dop C, Donohoue P A, Jabs K L, Bock G H, Fivush B A, Harmon W E
Division of Pediatric Endocrinology, University of California School of Medicine, Los Angeles.
J Pediatr. 1991 May;118(5):708-14. doi: 10.1016/s0022-3476(05)80031-9.
We performed oral glucose tolerance tests (oGTTs) on 15 children who had functioning renal allografts received greater than or equal to 18 months previously, had adequate renal function, and had heights greater than 2.5 SD below the mean height for age. Three of the children had impaired glucose tolerance; their mean glucose levels during the last 2 hours of the oGTT were higher (p less than 0.05) than published control values. Integrated glucose concentrations correlated inversely with the prednisone dose on the first day of an alternate-day dosage schedule (R2 = 0.383) and directly with adiposity (partial R2 = 0.322). The integrated insulin concentration correlated directly with the prednisone dose on day 1 of an alternate-day regimen (R2 = 0.355) and with age (partial R2 = 0.163). In 10 children with renal transplants who had been treated with growth hormone for greater than or equal to 6 months, the mean fasting glucose concentration, integrated glucose concentration, and integrated insulin concentration during the oGTTs obtained after 6 months or 12 months of growth hormone treatment were not significantly different (p greater than 0.05) from values measured before the treatment. We conclude that increased integrated concentrations of both glucose and insulin during oGTTs in children with renal allografts correlate with the dose of prednisone administered on the first day of an alternate-day schedule, with age, and with adiposity index. Growth hormone treatment of children with renal allografts who are growing poorly does not significantly affect glucose metabolism as assessed by oGTT.
我们对15名儿童进行了口服葡萄糖耐量试验（oGTT），这些儿童此前已接受功能正常的同种异体肾移植18个月及以上，肾功能良好，且身高低于同年龄平均身高2.5个标准差。其中3名儿童糖耐量受损；他们在oGTT最后2小时的平均血糖水平高于已发表的对照值（p<0.05）。在隔日给药方案的第一天，累积葡萄糖浓度与泼尼松剂量呈负相关（R2 = 0.383），与肥胖程度呈正相关（偏R2 = 0.322）。累积胰岛素浓度与隔日给药方案第一天的泼尼松剂量呈正相关（R2 = 0.355），与年龄呈正相关（偏R2 = 0.163）。在10名接受生长激素治疗6个月及以上的肾移植儿童中，生长激素治疗6个月或12个月后进行oGTT时的平均空腹血糖浓度、累积葡萄糖浓度和累积胰岛素浓度与治疗前测量值相比无显著差异（p>0.05）。我们得出结论，肾移植儿童在oGTT期间葡萄糖和胰岛素的累积浓度增加与隔日给药方案第一天给予的泼尼松剂量、年龄和肥胖指数相关。对于生长发育不良的肾移植儿童，生长激素治疗并未如通过oGTT评估的那样显著影响葡萄糖代谢。
