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生长激素治疗是否会影响矮小孩子的青春期发育?

Does growth hormone treatment influence pubertal development in short children?

机构信息

Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy-University of Gothenburg, Gothenburg, Sweden.

出版信息

Horm Res Paediatr. 2011;76(4):262-72. doi: 10.1159/000329743. Epub 2011 Sep 14.

Abstract

AIM

To study the influence of growth hormone (GH) treatment on the initiation and progression of puberty in short children.

METHODS

This prospective, randomized, controlled study included 124 short children (33 girls) who received GH treatment (Genotropin®; Pfizer Inc.) from a mean age of 11 years until near adult height [intent-to-treat (ITT) population]. Children were randomized into three groups: controls (n = 33), GH 33 μg/kg/day (n = 34) or GH 67 μg/kg/day (n = 57). Prepubertal children at study start constituted the per-protocol (PP) population (n = 101). Auxological measurements were made and puberty was staged every 3 months. Serum sex-steroid concentrations were assessed every 6 months.

RESULTS

No significant differences were found between the groups, of both PP and ITT populations, in time elapsed from start of treatment until either onset of puberty, age at start of puberty or age at final pubertal maturation in either sex. In the ITT population, pubertal duration was significantly longer in GH-treated girls, and maximum mean testicular volume was significantly greater in GH-treated boys than controls, but there were no differences in testosterone levels between the groups.

CONCLUSION

GH treatment did not influence age at onset of puberty and did not accelerate pubertal development. In boys, GH treatment appeared to increase testicular volume.

摘要

目的

研究生长激素(GH)治疗对矮小儿童青春期启动和进展的影响。

方法

这是一项前瞻性、随机、对照研究,纳入了 124 名矮小儿童(33 名女孩),他们从平均 11 岁开始接受 GH 治疗(Genotropin®;辉瑞公司),直至接近成人身高[意向治疗(ITT)人群]。儿童被随机分为三组:对照组(n=33)、GH 33μg/kg/天组(n=34)或 GH 67μg/kg/天组(n=57)。研究开始时的青春前期儿童构成了符合方案(PP)人群(n=101)。进行了体格测量,并每 3 个月进行一次青春期分期。每 6 个月评估一次血清性激素浓度。

结果

在 PP 和 ITT 人群中,从治疗开始到青春期开始、青春期开始年龄或性别的最终青春期成熟年龄的时间,各组之间均无显著差异。在 ITT 人群中,GH 治疗的女孩青春期持续时间明显延长,GH 治疗的男孩最大平均睾丸体积明显大于对照组,但两组之间的睾酮水平无差异。

结论

GH 治疗并未影响青春期开始的年龄,也未加速青春期发育。在男孩中,GH 治疗似乎增加了睾丸体积。

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