Miller Bradley S, Aydin Ferah, Lundgren Frida, Lindberg Anders, Geffner Mitchell E
Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, Minn., USA.
Horm Res Paediatr. 2014;82(1):31-7. doi: 10.1159/000360005. Epub 2014 Jun 11.
Children receiving stimulants for attention deficit hyperactivity disorder (ADHD) frequently present to pediatric endocrinology clinics for evaluation and treatment of growth disorders. The worldwide prevalence of stimulant use in children with ADHD also receiving recombinant human growth hormone (rhGH) and the impact on response to rhGH are unknown.
Data on children enrolled in the KIGS® (Pfizer International Growth Study) registry were evaluated for the associated diagnosis of ADHD prior to initiation of Genotropin® rhGH. Concomitant stimulant medications and auxological information were captured. Response to rhGH was evaluated using established growth prediction models.
The prevalence of ADHD in KIGS was 2.3% (1,748/75,251), with stimulants used in 1.8% (1,326/75,251). Children with idiopathic growth hormone deficiency (IGHD) who received stimulants grew significantly less (1.1 cm) in the first year of rhGH therapy than expected for rhGH-treated non-ADHD IGHD children. After one year of rhGH, idiopathic short stature (ISS) children with ADHD were significantly shorter [0.74 cm (with stimulants) and 0.69 cm (without stimulants)] than non-ADHD ISS children.
We demonstrated an impaired response to rhGH in IGHD and ISS children with ADHD. Our findings suggest that the ADHD phenotype, alone or in conjunction with stimulant therapy, may impair the short-term growth response to rhGH.
接受兴奋剂治疗注意力缺陷多动障碍（ADHD）的儿童经常前往儿科内分泌诊所评估和治疗生长障碍。在同时接受重组人生长激素（rhGH）治疗的ADHD儿童中，全球范围内兴奋剂的使用 prevalence 以及对rhGH反应的影响尚不清楚。
对参加KIGS®（辉瑞国际生长研究）登记处的儿童数据进行评估，以确定在开始使用Genotropin® rhGH之前是否存在ADHD相关诊断。记录同时使用的兴奋剂药物和生长发育信息。使用既定的生长预测模型评估对rhGH的反应。
KIGS中ADHD的患病率为2.3%（1748/75251），其中1.8%（1326/75251）使用了兴奋剂。接受兴奋剂治疗的特发性生长激素缺乏症（IGHD）儿童在rhGH治疗的第一年生长明显少于未患ADHD的IGHD儿童预期的生长量（少1.1厘米）。rhGH治疗一年后，患有ADHD的特发性矮小症（ISS）儿童比未患ADHD的ISS儿童明显更矮[使用兴奋剂的矮0.74厘米，未使用兴奋剂的矮0.69厘米]。
我们证明了患有ADHD的IGHD和ISS儿童对rhGH的反应受损。我们的研究结果表明，ADHD表型单独或与兴奋剂治疗相结合，可能会损害对rhGH的短期生长反应。
