Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine Chicago, 645 N. Michigan Avenue, Suite 530 Chicago, IL 60611, USA.
J Endocrinol Invest. 2011 Feb;34(2):150-4. doi: 10.1007/BF03347046. Epub 2011 Jan 26.
The approval of GH treatment of adults with GH deficiency (GHD) raises issues regarding continuation of GH treatment in the GH-deficient child following achievement of near adult height. The transition period begins in late puberty and ends with full adult maturation and includes hormonal and many lifestyle changes. Children treated with GH should be retested near the time of reaching adult height to determine if they have persistence of GHD. Although most children with organic causes of GHD will again be found to have GHD on retesting, most of those with idiopathic GHD will not. Retesting usually involves measurement of IGF-I and stimulation with insulin-induced hypoglycemia or arginine-GHRH, but important questions remain about adjustment of established cut-offs for age and body mass index. Most studies have shown the benefit of GH treatment in young adults with GHD in body composition, especially the achievement of peak bone mass. It is important for pediatric endocrinologists to discuss the potential need for continued treatment beyond achievement of adult height at the time of initiation of GH treatment, especially in those children with organic causes of GHD.
GH 治疗成人生长激素缺乏症（GHD）的获批引发了一个问题，即在达到接近成人身高后，对于 GH 缺乏的儿童是否继续进行 GH 治疗。这个过渡阶段始于青春期后期，结束于完全成年成熟，包括荷尔蒙和许多生活方式的改变。接受 GH 治疗的儿童应在接近达到成人身高时进行重新测试，以确定他们是否仍然存在 GHD。尽管大多数因器质性原因导致 GHD 的儿童在重新测试时仍被发现存在 GHD，但大多数特发性 GHD 的儿童则不会。重新测试通常涉及 IGF-I 的测量以及胰岛素诱导的低血糖或精氨酸-GHRH 刺激，但关于年龄和体重指数的既定截止值的调整仍存在重要问题。大多数研究表明，GH 治疗对年轻的 GHD 成年人在身体成分方面有益，特别是在实现峰值骨量方面。儿科内分泌学家在开始 GH 治疗时，就应讨论在达到成人身高后是否需要继续治疗的可能性，尤其是对于那些因器质性原因导致 GHD 的儿童。
