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短期生长激素治疗特发性身材矮小青春期前儿童的疗效。

Efficacy of short-term growth hormone treatment in prepubertal children with idiopathic short stature.

机构信息

Department of Pediatrics, Sowha Children's Hospital, 383 Cheongpa-ro, Yongsan-gu, Seoul 148-829, Korea.

出版信息

Yonsei Med J. 2014 Jan;55(1):53-60. doi: 10.3349/ymj.2014.55.1.53.

Abstract

PURPOSE

It has been reported that daily recombinant human growth hormone (GH) treatment showed beneficial effects on growth in prepubertal children with idiopathic short stature (ISS). The present study aimed to validate the GH (Eutropin®) effect on growth promotion and safety after short-term GH treatment.

MATERIALS AND METHODS

This study was an open-label, multicenter, interventional study conducted at nine university hospitals in Korea between 2008 and 2009. Thirty six prepubertal children with ISS were enrolled in this study to receive 6-month GH treatment. Yearly growth rate, height standard deviation score (SDS), and adverse events were investigated during treatment.

RESULTS

After 26 weeks of GH treatment, the height velocity significantly increased by 6.36±3.36 cm/year (p<0.001). The lower end of one-sided 95% confidence interval was 5.22 cm/year, far greater than the predefined effect size. The gain in height SDS at week 26 was 0.57±0.27 (p<0.0001). Bone age significantly increased after GH treatment, however, bone maturation rate (bone age for chronological age) showed limited advancement. This 26-week GH treatment was effective in increasing serum levels of insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-3 from baseline (p<0.0001). Eutropin was well tolerated and there were no withdrawals due to adverse events. No clinically significant changes in laboratory values were observed.

CONCLUSION

This 6-month daily GH treatment in children with ISS demonstrated increased height velocity, improved height SDS, and increased IGF-I and IGFBP-3 levels with a favorable safety profile.

摘要

目的

有报道称,每日重组人生长激素(GH)治疗对特发性身材矮小症(ISS)的青春期前儿童的生长有有益影响。本研究旨在验证 GH(Eutropin®)短期治疗后促进生长和安全性的作用。

材料和方法

这是一项于 2008 年至 2009 年在韩国 9 所大学医院进行的开放性、多中心、干预性研究。本研究纳入了 36 名 ISS 青春期前儿童,他们接受了 6 个月的 GH 治疗。在治疗期间,研究了每年的生长速度、身高标准差评分(SDS)和不良事件。

结果

GH 治疗 26 周后,身高增速显著增加 6.36±3.36cm/年(p<0.001)。单侧 95%置信区间的下限为 5.22cm/年,远大于预设的效应量。26 周时身高 SDS 的增加为 0.57±0.27(p<0.0001)。GH 治疗后骨龄显著增加,但骨成熟率(骨龄与实际年龄之比)显示进展有限。这种 26 周的 GH 治疗可有效增加 IGF-I 和 IGFBP-3 的血清水平(p<0.0001)。Eutropin 具有良好的耐受性,没有因不良事件而退出。实验室值无临床显著变化。

结论

本研究中,ISS 儿童接受 6 个月的每日 GH 治疗可提高身高增速、改善身高 SDS、提高 IGF-I 和 IGFBP-3 水平,且安全性良好。

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