Tanaka Toshiaki, Fujieda Kenji, Yokoya Susumu, Shimatsu Akira, Tachibana Katsuhiko, Tanaka Hiroyuki, Tanizawa Takakuni, Teramoto Akira, Nagai Toshiro, Nishi Yoshikazu, Hasegawa Yukihiro, Hanew Kunihiko, Fujita Keinosuke, Horikawa Reiko, Takada Goro, Miyashita Masao, Ohno Tadashi, Komatsu Kazuo
Study Group of Growth Hormone Treatment, the Foundation for Growth Science, Japan ; Department of Clinical Laboratory Medicine, National Center for Child Health and Development, Tokyo, Japan.
Study Group of Growth Hormone Treatment, the Foundation for Growth Science, Japan.
Clin Pediatr Endocrinol. 2006;15(1):15-21. doi: 10.1297/cpe.15.15. Epub 2006 Feb 22.
It is still in doubt whether the standard-dose growth hormone (GH) used in Japan (0.5 IU/kg/week, 0.167 mg/kg/week) for growth hormone deficiency is effective for achieving significant adult height improvement in non-growth hormone deficient (non-GHD) short children. We compared the growth of GH-treated non-GHD short children with that of untreated short children to examine the effect of standard-dose GH treatment on non-GHD short children. GH treatment with recombinant human growth hormone (rhGH) was started before the age of 11 yr in 64 boys and 76 girls with non-GHD short stature registered at the Foundation for Growth Science who have now reached their adult height. In 119 untreated boys and 127 untreated girls whose height standard deviation score (SDS) was below -2 SD at the age of 6 yr, height growth was followed until 17 yr. Height SDS was significantly lower before GH treatment in the GH-treated group than at the age of 6 yr in the untreated group, in both sexes. Adult height and adult height SDS were significantly greater in the untreated group than in the GH-treated group, in both sexes, although the change in height SDS did not differ significantly. Height SDS was significantly lower before GH treatment in the GH-treated group than at the age of 6 yr in the untreated group, so 57 boys and 57 girls whose height SDS at the age of 6 yr in the untreated group closely matched the height SDS before GH treatment in the GH-treated group were chosen for comparison. Height SDS did not differ significantly between the GH-treated group before GH treatment and the untreated group at the age of 6 yr, nor were there differences between these subgroups in adult height, adult height SDS, or height SDS change, in either sex. The effect of GH treatment is reported to be dose-dependent and doses over 0.23 mg/kg/week are reported to be necessary to improve adult height in non-GHD short children. Currently, the GH dose is fixed at 0.175 mg/kg/week in Japan, and we expected to find, and indeed concluded, that ordinary GH treatment in Japanese, non-GHD short children does not improve adult height.
日本用于治疗生长激素缺乏症的标准剂量生长激素(GH)(0.5 IU/kg/周,0.167 mg/kg/周)对非生长激素缺乏(非GHD)的矮小儿童显著提高成人身高是否有效仍存疑问。我们比较了接受GH治疗的非GHD矮小儿童与未治疗的矮小儿童的生长情况,以研究标准剂量GH治疗对非GHD矮小儿童的影响。64名男孩和76名女孩在生长科学基金会登记,患有非GHD矮小身材,现已达到成人身高,他们在11岁之前开始用重组人生长激素(rhGH)进行GH治疗。在119名未治疗的男孩和127名未治疗的女孩中,他们在6岁时身高标准差评分(SDS)低于-2 SD,对其身高增长情况进行跟踪直至17岁。在接受GH治疗的组中,治疗前身高SDS显著低于未治疗组6岁时的身高SDS,男女皆是如此。在未治疗组中,成人身高和成人身高SDS在男女中均显著高于接受GH治疗的组,尽管身高SDS的变化没有显著差异。在接受GH治疗的组中,治疗前身高SDS显著低于未治疗组6岁时的身高SDS,因此选择了57名男孩和57名女孩进行比较,他们在未治疗组6岁时的身高SDS与接受GH治疗组治疗前的身高SDS紧密匹配。接受GH治疗组治疗前的身高SDS与未治疗组6岁时的身高SDS没有显著差异,在成人身高、成人身高SDS或身高SDS变化方面,这些亚组在男女中也没有差异。据报道,GH治疗的效果是剂量依赖性的,据报道,非GHD矮小儿童要提高成人身高,每周剂量需超过0.23 mg/kg。目前,日本的GH剂量固定为0.175 mg/kg/周,我们预期并确实得出结论,日本非GHD矮小儿童的普通GH治疗并不能提高成人身高。