Cappa M, Caruso M, Saggese G, Salerno M C, Tonini G
Unit of Endocrinology and Diabetic Bambino Gesù Children's Hospital IRCCS, Rome, Italy -
Minerva Endocrinol. 2015 Mar;40(1):23-35.
Growth hormone (GH) has been recently approved by the Italian Health Authorities for use in transition patients with childhood onset-growth hormone deficiency (CO-GHD). GH in addition to promote linear growth influences several key metabolic processes. In particular, in the transition period, from late adolescent to early adulthood, GH plays an important role in the achievement of a complete somatic development including body composition, muscle mass maturation, full skeletal mineralization and reproductive maturation, as well as in the prevention of metabolic and cardiovascular risk. Therefore, GH replacement should be restarted if a GH stimulation test at the re-evaluation fulfills established criteria. Endocrinologists experienced in the care of GHD adolescent patients held a workshop in Rome, Italy in July 2012 to review in detail the literature data and compare experiences of five Italian endocrinological centers on the negative consequences of interrupting GH treatment and the positive effects of continued GH replacement on intermediary metabolism, heart, muscle, pubertal development, and bone. The aim of the meeting was to delineate the state of the art on GH therapy in transition age and provide suggestions to pediatric and adult endocrinologists for a smooth transition care.
生长激素（GH）最近已获意大利卫生当局批准，用于患有儿童期起病型生长激素缺乏症（CO-GHD）的过渡期患者。GH除了促进线性生长外，还会影响多个关键的代谢过程。特别是在从青少年晚期到成年早期的过渡期，GH在实现包括身体成分、肌肉质量成熟、完全骨骼矿化和生殖成熟在内的完整躯体发育，以及预防代谢和心血管风险方面发挥着重要作用。因此，如果重新评估时的GH刺激试验符合既定标准，就应重新开始GH替代治疗。2012年7月，在意大利罗马，负责治疗GHD青少年患者的内分泌专家举办了一次研讨会，详细回顾文献数据，并比较了意大利五个内分泌中心关于中断GH治疗的负面后果以及持续GH替代对中间代谢、心脏、肌肉、青春期发育和骨骼的积极影响的经验。会议的目的是勾勒出过渡期GH治疗的现状，并为儿科和成人内分泌专家提供建议，以实现平稳的过渡护理。
