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儿童时期发病的生长激素缺乏症(GHD)成年患者的死亡率和社会经济地位高度取决于 GHD 的主要病因。

Mortality and socioeconomic status in adults with childhood onset GH deficiency (GHD) is highly dependent on the primary cause of GHD.

机构信息

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.

出版信息

Eur J Endocrinol. 2012 Nov;167(5):663-70. doi: 10.1530/EJE-11-1084. Epub 2012 Aug 23.

DOI:10.1530/EJE-11-1084
PMID:22918302
Abstract

OBJECTIVE

Childhood onset GH deficiency (CO-GHD) is associated with increased morbidity and mortality; however, the patients' socioeconomic profile as adults is not fully known.

DESIGN

Register study using Danish nationwide registries. Two hundred and sixty GHD males and 156 GHD females and 25,358 male and 15,110 female controls were included.

METHODS

Information was obtained concerning cohabitation, parenthood, education, income, retirement, convictions, and death. Income was analyzed using conditional logistic regression, and other outcomes were analyzed using Cox regression. Subgroups of GHD patients with malignant tumors, craniopharyngioma, idiopathic GHD, and others were investigated separately.

RESULTS

Both male and female GHD patients had a significantly worse outcome on all studied socioeconomic parameters. Fewer GHD patients lived in partnerships and entered them later (male hazard ratio (HR): 0.31; female HR: 0.33), had fewer parenthoods (male HR: 0.26; female HR: 0.26), lower educational level (male HR: 0.58; female HR: 0.48), lower income, higher risk of retirement (male HR: 13.4; female HR: 24.2), and fewer convictions (male HR: 0.67; female HR: 0.49). Mortality was increased (male HR: 10.7; female HR: 21.4). Adjusted for marital and educational status, male HR of death was 5.2 and female HR 10.5. Patients with idiopathic GHD had a socioeconomic profile similar to controls.

CONCLUSION

The primary causes of CO-GHD and concomitant diseases severely impair socioeconomic conditions and impact mortality; only the subgroup of patients with idiopathic GHD conditions was similar to the background population.

摘要

目的

儿童期发病的生长激素缺乏症(CO-GHD)与发病率和死亡率的增加有关;然而,成年患者的社会经济状况尚不完全清楚。

设计

使用丹麦全国性登记处进行注册研究。纳入 260 名男性 GH 缺乏症患者、156 名女性 GH 缺乏症患者和 25358 名男性对照者、15110 名女性对照者。

方法

获取关于同居、生育、教育、收入、退休、定罪和死亡的信息。使用条件逻辑回归分析收入,使用 Cox 回归分析其他结果。分别对患有恶性肿瘤、颅咽管瘤、特发性 GH 缺乏症等的 GH 缺乏症患者亚组进行了研究。

结果

男性和女性 GH 缺乏症患者在所有研究的社会经济参数上的结果均显著较差。患有 GH 缺乏症的患者较少处于伴侣关系中,且进入伴侣关系的时间较晚(男性危险比(HR):0.31;女性 HR:0.33),生育子女较少(男性 HR:0.26;女性 HR:0.26),教育程度较低(男性 HR:0.58;女性 HR:0.48),收入较低,退休风险较高(男性 HR:13.4;女性 HR:24.2),定罪较少(男性 HR:0.67;女性 HR:0.49)。死亡率增加(男性 HR:10.7;女性 HR:21.4)。调整婚姻和教育状况后,男性死亡 HR 为 5.2,女性 HR 为 10.5。特发性 GH 缺乏症患者的社会经济状况与对照组相似。

结论

CO-GHD 的主要病因和并存疾病严重损害了社会经济状况,并影响了死亡率;只有特发性 GH 缺乏症患者亚组的情况与基础人群相似。

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