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日本特发性生长激素缺乏症儿童生长激素治疗后的成人身高:来自日本KIGS数据库的分析

Adult height after growth hormone treatment in Japanese children with idiopathic growth hormone deficiency: analysis from the KIGS Japan database.

作者信息

Fujieda Kenji, Tanaka Toshiaki, Takano Kazue, Chihara Kazuo, Seino Yoshiki, Irie Minoru

机构信息

Department of Pediatrics, Asahikawa Medical College, Asahikawa, Japan.

出版信息

J Pediatr Endocrinol Metab. 2011;24(7-8):457-62. doi: 10.1515/jpem.2011.212.

Abstract

OBJECTIVE

To identify factors affecting adult height in Japanese patients with idiopathic growth hormone deficiency (GHD), who received growth hormone (GH) treatment during childhood.

METHODS

A retrospective pharmaco-epidemiological study of the effect of GH treatment on adult height standard deviation scores (SDS) was conducted in 374 Japanese patients with idiopathic GHD. During childhood, GH (0.146 +/- 0.023 mg/kg/week) was administered for a mean of 6.4 +/- 2.6 years.

RESULTS

The mean adult height was 160.6 +/- 6.3 cm (-1.75 SD; n = 232) in boys and 146.9 +/- 7.3 cm (-2.20 SD; n = 158) in girls after GH therapy. The mean increases in height SDS in boys and girls with severe GHD were 2.13 SD and 1.66 SD, respectively (p < 0.05). These increases were greater than those observed in patients with moderate GHD and mild GHD. The mean adult height of male patients with GHD and gonadotropin deficiency (166.8 cm) was significantly higher (p < 0.05) than that of isolated GHD patients who were either receiving (159.1 cm) or not receiving (160.5 cm) gonadal suppression therapy. The mean adult heights of female patients were 149.6, 146.7, and 146.9 cm, respectively, and these values did not significantly differ.

CONCLUSION

Linear multiple regression analyses of Japanese patients with severe GHD (n = 61) revealed three independent variables that influenced adult height: gonadotropin deficiency, initial height SDS and height velocity during the first year after the initiation of GH therapy.

摘要

目的

确定影响童年期接受生长激素(GH)治疗的日本特发性生长激素缺乏症(GHD)成年患者身高的因素。

方法

对374例日本特发性GHD患者进行了一项关于GH治疗对成年身高标准差评分(SDS)影响的回顾性药物流行病学研究。童年期,平均6.4±2.6年给予GH(0.146±0.023mg/kg/周)。

结果

GH治疗后,男孩的平均成年身高为160.6±6.3cm(-1.75SD;n = 232),女孩为146.9±7.3cm(-2.20SD;n = 158)。重度GHD男孩和女孩的身高SDS平均增加分别为2.13SD和1.66SD(p<0.05)。这些增加大于中度GHD和轻度GHD患者的增加。患有GHD和促性腺激素缺乏症的男性患者的平均成年身高(166.8cm)显著高于接受(159.1cm)或未接受(160.5cm)性腺抑制治疗的单纯GHD患者(p<0.05)。女性患者的平均成年身高分别为149.6、146.7和146.9cm,这些值无显著差异。

结论

对重度GHD日本患者(n = 61)的线性多元回归分析显示,影响成年身高的三个独立变量为:促性腺激素缺乏、初始身高SDS和GH治疗开始后第一年的身高增长速度。

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