Schena Lucia, Meazza Cristina, Pagani Sara, Paganelli Valeria, Bozzola Elena, Tinelli Carmine, Buzi Fabio, Bozzola Mauro
J Pediatr Endocrinol Metab. 2017 Feb 1;30(2):197-201. doi: 10.1515/jpem-2016-0297.
In recent years, several studies have been published showing different responses to growth hormone (GH) treatment in idiopathic short stature children. The aim of the present study was to investigate whether non-growth-hormone-deficient (non-GHD) short children could benefit from long-term GH treatment as GHD patients.
We enrolled 22 prepubertal children and 22 age- and sex-matched GHD patients, with comparable height, body mass index (BMI), bone age, and insulin-like growth factor 1 (IGF-I) circulating levels. The patients were treated with recombinant human GH (rhGH) and followed until they reach adult height.
During GH treatment, the two groups grew in parallel, reaching the same final height-standard deviation score (SDS) and the same height gain. On the contrary, we found significantly lower IGF-I serum concentrations in non-GHD patients than in GHD ones, at the end of therapy (p=0.0055).
In our study, the response to GH treatment in short non-GHD patients proved to be similar to that in GHD ones. However, a careful selection of short non-GHD children to be treated with GH would better justify the cost of long-term GH therapy.
近年来,已有多项研究发表,显示特发性身材矮小儿童对生长激素(GH)治疗有不同反应。本研究的目的是调查非生长激素缺乏(非GHD)的矮小儿童是否能像生长激素缺乏症(GHD)患者一样从长期GH治疗中获益。
我们纳入了22名青春期前儿童和22名年龄及性别匹配的GHD患者,他们在身高、体重指数(BMI)、骨龄和胰岛素样生长因子1(IGF-I)循环水平方面具有可比性。患者接受重组人生长激素(rhGH)治疗,并随访至达到成人身高。
在GH治疗期间,两组平行生长,达到相同的最终身高标准差得分(SDS)和相同的身高增长。相反,在治疗结束时,我们发现非GHD患者的IGF-I血清浓度显著低于GHD患者(p = 0.0055)。
在我们的研究中,矮小非GHD患者对GH治疗的反应被证明与GHD患者相似。然而,仔细挑选接受GH治疗的矮小非GHD儿童将更能证明长期GH治疗费用的合理性。