体质指数对身材矮小儿童可乐定刺激试验生长激素反应的影响。

Effect of body mass index on the growth hormone response to clonidine stimulation testing in children with short stature.

机构信息

Servizio di Endocrinologia Pediatrica, Ospedale Microcitemico, ASL Cagliari, Cagliari, Italy.

出版信息

Clin Endocrinol (Oxf). 2011 Jun;74(6):726-31. doi: 10.1111/j.1365-2265.2011.03988.x.

DOI:10.1111/j.1365-2265.2011.03988.x

PMID:21521260

Abstract

OBJECTIVES

An inverse relationship has been shown between body mass index (BMI) and the peak growth hormone (GH) response to stimulation in adults and in children with short stature. This relation is observed even within a normal range of BMI. The aim of this study was to investigate the effect of BMI on the GH response to clonidine in a large number of children with short stature.

DESIGN

We conducted a retrospective study on the GH response to clonidine in a single centre.

METHODS

We studied 202 children with short stature (135 M and 67 F) who underwent clonidine testing from 2007 to 2009.

RESULTS

One hundred and twenty-eight patients had a GH peak >10 μg/l. In univariate regression analysis, the peak GH after clonidine was negatively correlated with BMI-standard deviation score (BMI-SDS) and positively correlated with height velocity-SDS and IGF-I-SDS. Only the relationship between peak GH and BMI-SDS remained significant in children with a BMI-SDS from -2 to +2. In the multivariate stepwise regression analysis, BMI-SDS and IGF-I-SDS were the only significant variables in the entire cohort, explaining 19·5% of the variance in peak GH. When only subjects with BMI-SDS between -2·0 and +2·0 were included in the analysis (n = 173), BMI-SDS alone explained 21·4% of the variability in peak GH. The number of patients who failed the clonidine test increased with increasing BMI-SDS.

CONCLUSIONS

BMI affects the GH response to clonidine in children with short stature and should be considered when interpreting the results to the stimulation test.

摘要

目的

体重指数（BMI）与刺激后生长激素（GH）峰值之间呈负相关，这一关系在成年人和身材矮小的儿童中均有观察到。即使在 BMI 的正常范围内也是如此。本研究旨在调查 BMI 对大量身材矮小儿童可乐定刺激后 GH 反应的影响。

设计

我们对单一中心的可乐定刺激 GH 反应进行了回顾性研究。

方法

我们研究了 2007 年至 2009 年间接受可乐定试验的 202 名身材矮小的儿童（135 名男性和 67 名女性）。

结果

128 名患者 GH 峰值>10μg/l。在单因素回归分析中，可乐定后 GH 峰值与 BMI 标准差评分（BMI-SDS）呈负相关，与身高速度-SDS 和 IGF-I-SDS 呈正相关。只有 BMI-SDS 为-2 至+2 的儿童中，GH 峰值与 BMI-SDS 之间的关系仍然具有显著性。在多元逐步回归分析中，BMI-SDS 和 IGF-I-SDS 是整个队列中唯一的显著变量，解释了 GH 峰值变化的 19.5%。当仅将 BMI-SDS 在-2.0 至+2.0 之间的受试者纳入分析（n=173）时，BMI-SDS 单独解释了 GH 峰值变异性的 21.4%。可乐定试验失败的患者数量随 BMI-SDS 的增加而增加。