Paediatric Endocrinology Section, University Children's Hospital, Tuebingen, Germany.
Horm Res Paediatr. 2012;78(1):8-17. doi: 10.1159/000339468. Epub 2012 Jul 24.
BACKGROUND/AIMS: The study aim was to develop and validate models for long-term prediction of growth in prepubertal children with idiopathic growth hormone deficiency (GHD) or Turner syndrome (TS) for optimal, cost-effective growth hormone (GH) therapy.
Height was predicted by sequential application of annual prediction algorithms for height velocity in cohorts of GHD (n = 664) and TS (n = 607) as documented within KIGS (Pfizer International Growth Database). As height prediction models also require an estimate of weight, new algorithms for weight increase during the first to fourth prepubertal years on GH were developed.
When height was predicted from the start of GH treatment, the predicted and observed mean (SD) gain over 4 years was 30.4 (3.4) cm and 30.1 (4.9) cm, respectively, in GHD patients, and 27.2 (2.2) cm and 26.6 (3.5) cm, respectively, in TS patients. For all 4 years, gains of weight SD scores (SDS) were accurately described as a function of weight SDS and observed gain in height SDS (R(2) > 0.89).
In GHD and TS patients treated with GH, an accurate prepubertal long-term prediction of height development in groups is possible. Based on this, an optimal individual height outcome could be simulated.
背景/目的:本研究旨在为特发性生长激素缺乏症(GHD)或特纳综合征(TS)患儿建立并验证长期生长预测模型,以实现最佳、具成本效益的生长激素(GH)治疗。
通过对 KIGS(辉瑞国际生长数据库)中 GHD(n=664)和 TS(n=607)队列的身高年预测算法的连续应用,预测身高。由于身高预测模型还需要体重估计,因此开发了新的 GH 治疗最初 4 年期间体重增加的算法。
当从 GH 治疗开始时预测身高时,GHD 患者的 4 年平均(SD)增长预测值和观察值分别为 30.4(3.4)cm 和 30.1(4.9)cm,TS 患者分别为 27.2(2.2)cm 和 26.6(3.5)cm。对于所有 4 年,体重 SDS 的增长准确地描述为体重 SDS 和观察到的身高 SDS 增长的函数(R²>0.89)。
在接受 GH 治疗的 GHD 和 TS 患者中,对群体的青春期前长期身高发育进行准确预测是可行的。在此基础上,可以模拟出最佳的个体身高结果。