Xue Ying, Gao Yiqing, Wang Shuqin, Wang Pei
Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China.
Exp Ther Med. 2016 May;11(5):1647-1652. doi: 10.3892/etm.2016.3091. Epub 2016 Feb 19.
The aim of the present study was to examine the effects of different doses of recombinant human growth hormone (rhGH) on children with growth hormone deficiency (GHD) and on thyroid and glucose metabolism to identify more reasonable therapeutic doses of growth hormone (GH) for the treatment of this condition. In total, 60 prepubertal patients with GHD were randomly divided into the high-dose and low-dose groups (n=30 per group). The groups were treated with 0.1 or 0.05 U/kg for 6 months, respectively. The follow-up study focused on changes to the serum levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein (IGFBP)-3, blood glucose, thyroid hormone [triiodothyronine (T3) and its prohormone, thyroxine (T4), and thyroid stimulating hormone (TSH)] and the analysis of variance of the repeated data. Changes in the height, body weight and bone age of the high-dose group were greater than those of the low-dose group. After 6 months of treatment, the difference in height between the two groups was statistically significant (P<0.05). Glucose metabolism in the two groups was consistent, but there was a statistically significant difference in the fasting blood glucose (FBG) levels of the two groups after 6 months of treatment (P<0.05). Prior to treatment, the T3, T4 and TSH values (the thyroid function tests) in the two groups, especially for the value of T3 in high-dose group were varied. However, 6 months after treatment, statistically significant differences between the two groups (P<0.05) were identified. In conclusion, 0.1 U/kg of GH is beneficial to children with GHD in attaining a satisfactory height, but it leads to insulin resistance. Thus, glucose metabolism and thyroid function should be monitored on a regular basis in a clinical setting.
本研究的目的是探讨不同剂量重组人生长激素(rhGH)对生长激素缺乏症(GHD)儿童以及甲状腺和糖代谢的影响,以确定治疗该疾病更合理的生长激素(GH)治疗剂量。总共60例青春期前GHD患者被随机分为高剂量组和低剂量组(每组n = 30)。两组分别接受0.1或0.05 U/kg的治疗,为期6个月。随访研究重点关注血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白(IGFBP)-3、血糖、甲状腺激素[三碘甲状腺原氨酸(T3)及其前体激素甲状腺素(T4)和促甲状腺激素(TSH)]水平的变化以及重复数据的方差分析。高剂量组的身高、体重和骨龄变化大于低剂量组。治疗6个月后,两组身高差异有统计学意义(P<0.05)。两组的糖代谢情况一致,但治疗6个月后两组空腹血糖(FBG)水平有统计学差异(P<0.05)。治疗前,两组的T3、T4和TSH值(甲状腺功能检查),尤其是高剂量组的T3值各不相同。然而,治疗6个月后,两组之间有统计学差异(P<0.05)。总之,0.1 U/kg的GH有利于GHD儿童达到满意身高,但会导致胰岛素抵抗。因此,在临床环境中应定期监测糖代谢和甲状腺功能。