University of Toronto, Toronto, Ontario, Canada.
J Pediatr. 2013 Feb;162(2):263-8.e1. doi: 10.1016/j.jpeds.2012.07.042. Epub 2012 Sep 2.
To review longitudinal polysomnography data to assess sleep-related disordered breathing (SRDB) before and up to 2 years after initiation of growth hormone (GH) therapy in children with Prader-Willi syndrome (PWS).
This was a retrospective review of systematic polysomnography evaluations performed in children with PWS before and at 6 weeks, 6 months, 1 year, and 2 years after initiation of GH therapy.
A total of 15 children with PWS were reviewed. At baseline, the median age was 3.7 years (range, 0.8-15.4 years), and the median body mass index percentile was 82.4 (range, 0-100). GH was discontinued in 2 of these 15 children owing to the occurrence of severe obstructive sleep apnea after 6 weeks of GH therapy. The remaining 13 children who were followed for up to 2 years on GH therapy demonstrated no statistically significant trends over time for any adverse sleep-related outcomes, specifically obstructive or central sleep apnea.
In young children with PWS with known SRDB at baseline, the first few weeks after initiation of GH therapy may represent a vulnerable time for the development of significant SRDB. However, most children with PWS did not show significant changes in SRDB after 2 years of GH therapy. We conclude that long-term GH therapy appears to be safe after an initial period of increased risk in the context of SRDB in children with PWS.
回顾纵向多导睡眠图数据，评估普瑞德-威利综合征（PWS）儿童在开始生长激素（GH）治疗前和治疗后长达 2 年的睡眠相关呼吸障碍（SRDB）情况。
这是一项对 PWS 儿童进行系统多导睡眠图评估的回顾性研究，评估时间为开始 GH 治疗前、6 周、6 个月、1 年和 2 年。
共回顾了 15 名 PWS 儿童。基线时，中位年龄为 3.7 岁（范围，0.8-15.4 岁），中位体重指数百分位数为 82.4（范围，0-100）。由于 2 名儿童在 GH 治疗 6 周后出现严重阻塞性睡眠呼吸暂停，停止了 GH 治疗。其余 13 名接受 GH 治疗长达 2 年的儿童在任何不良睡眠相关结果（特别是阻塞性或中枢性睡眠呼吸暂停）方面，没有随时间表现出统计学显著趋势。
在基线时存在已知 SRDB 的年轻 PWS 儿童中，GH 治疗开始后的最初几周可能是发生严重 SRDB 的脆弱时期。然而，大多数 PWS 儿童在接受 GH 治疗 2 年后，SRDB 没有明显变化。我们的结论是，长期 GH 治疗在 PWS 儿童的 SRDB 初始风险增加期过后似乎是安全的。
