Tanaka Toshiaki, Yokoya Susumu, Fujieda Kenji, Seino Yoshiki, Tada Hiroshi, Mishina Jun, Saito Susumu, Takata Ami, Ohki Nobuhiko
Tanaka Growth Clinic, Tokyo, Japan.
Clin Pediatr Endocrinol. 2012 Oct;21(4):57-68. doi: 10.1297/cpe.21.57. Epub 2012 Oct 30.
The efficacy and safety of 8 yr of GH treatment was assessed in 44 Japanese children with small for gestational age (SGA) short stature who met the criteria for GH treatment initiation (height SD score (SDS) <-2.5 SD) of the Japanese guidelines. Height SDS in subjects improved throughout the study period, and average height SDS improved from -3.5 to -1.6 and from -3.4 to -1.9 in the 0.033/0.067 mg and 0.067/0.067 mg groups, respectively, after 8 yr of GH treatment. Delta height SD was approximately +2 after 4 yr of treatment, and ∆ IGF-1 showed a significant positive correlation with ∆ height SD after both 1 and 2 yr (r = 0.415 and 0.488, respectively) of treatment. There was no correlation between the age at the start of treatment and age at onset of puberty, and the median age at the onset of puberty in the subjects was almost the same as that in healthy children. In conclusion, clinically significant improvements in the height SDS was confirmed in short children born SGA after 8 yr of GH treatment without any safety problems.
在44名符合日本指南中生长激素(GH)治疗起始标准(身高标准差评分(SDS)<-2.5 SD)的小于胎龄(SGA)矮小日本儿童中,评估了8年GH治疗的疗效和安全性。在整个研究期间,受试者的身高SDS有所改善,经过8年的GH治疗后,0.033/0.067 mg组和0.067/0.067 mg组的平均身高SDS分别从-3.5改善至-1.6以及从-3.4改善至-1.9。治疗4年后身高标准差变化量(Delta身高SD)约为+2,且在治疗1年和2年后,∆胰岛素样生长因子-1(IGF-1)与∆身高SD均呈显著正相关(r分别为0.415和0.488)。治疗开始时的年龄与青春期开始年龄之间无相关性,且受试者青春期开始的中位年龄与健康儿童几乎相同。总之,经8年GH治疗后,出生时为SGA的矮小儿童的身高SDS有临床显著改善,且无任何安全问题。