Okońska Maja, Birkholz Dorota, Korpal-Szczyrska Maria, Adamkiewicz-Drozyńska Elzbieta, Alska Anna, Magnuszewska Hanna
Klinika Pediatrii, Uniwersyteckie Centrum Kliniczne, Gdansk.
Pediatr Endocrinol Diabetes Metab. 2010;16(1):19-24.
Craniopharyngioma (CP) is a tumor, which damages pituitary function because of its localization. Panhypopituitarism (PHP) and excessive weight gain with lipid dysfunction are frequently observed. The growth hormone therapy (rGH) profits in the increase of growth rate and also may have metabolic effects like body weight reduction.
The evaluation of benefits from rGH therapy in patients cured from CP.
12 patients (7 boys and 5 girls) treated for CP with surgery; 3 of them also underwent radiotherapy. The mean age at examination time was 11.7 yrs; remission time 2.96 yrs; rGH therapy started on average 3.69 yrs after the surgery. Height (hSDS), weight, BMI were measured after the surgery, before and after 1 yr of rGH treatment. Height velocity (HV) was evaluated before and after 1 yr of rGH therapy. Pituitary GH-function was assessed. In addition, measurements of TSH, ACTH, LH, FSH. Cholesterol, LDL, HDL, triglycerides and HbA1c were estimated before and after one year of rGH therapy.
All patients presented PHP. The GH-peak average 1.53 mIU/l; IGF-1 39.37 ng/ml; TSH 0.1 U/l; ACTH 17.48 pg/ml; LH 0.13 U/l; FSH 0.41 mIU/ml. HSDS after oncological treatment (OT) average -1.66 SD and decreased significantly until rGH therapy; weight after OT average 28.45 kg and until rGH therapy increased significantly; BMI after OT average 19.26 and increased significantly until rGH therapy as well. HV was on average 3.34 cm/yr until rGH started. After one year of rGH therapy hSDS and HV increased significantly; they average -1.65SD and 10.21 cm/yr respectively. BMI, HbA1c and LDL decreased significantly. During rGH therapy neither tumor recurrence nor severe side effects were observed.
rGH therapy of patients cured from CP influences profitably not only growth rate, but also BMI reduction and the decrease in cholesterol LDL and HbA1c.
颅咽管瘤（CP）是一种因其位置而损害垂体功能的肿瘤。全垂体功能减退（PHP）以及伴有脂质功能障碍的体重过度增加经常可见。生长激素治疗（rGH）有利于提高生长速度，并且可能具有如减轻体重等代谢作用。
评估rGH治疗对CP治愈患者的益处。
12例接受手术治疗CP的患者（7例男孩和5例女孩）；其中3例还接受了放疗。检查时的平均年龄为11.7岁；缓解时间为2.96年；rGH治疗平均在手术后3.69年开始。在手术后、rGH治疗1年之前和之后测量身高（hSDS）、体重、体重指数（BMI）。在rGH治疗1年之前和之后评估身高增长速度（HV）。评估垂体生长激素功能。此外，在rGH治疗1年之前和之后测量促甲状腺激素（TSH）、促肾上腺皮质激素（ACTH）、促黄体生成素（LH）、促卵泡生成素（FSH）、胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯和糖化血红蛋白（HbA1c）。
所有患者均表现为PHP。生长激素峰值平均为1.53 mIU/l；胰岛素样生长因子-1（IGF-1）为39.37 ng/ml；TSH为0.1 U/l；ACTH为17.48 pg/ml；LH为0.13 U/l；FSH为0.41 mIU/ml。肿瘤治疗（OT）后的hSDS平均为-1.66标准差，在rGH治疗前显著下降；OT后的体重平均为28.45 kg，在rGH治疗前显著增加；OT后的BMI平均为19.26，在rGH治疗前也显著增加。在开始rGH治疗前，HV平均为3.34 cm/年。rGH治疗1年后，hSDS和HV显著增加；它们分别平均为-1.65标准差和10.21 cm/年。BMI、HbA1c和LDL显著下降。在rGH治疗期间，未观察到肿瘤复发或严重副作用。
CP治愈患者的rGH治疗不仅对生长速度有有益影响，而且能降低BMI以及胆固醇、LDL和HbA1c。
