Poidvin Amélie, Weill Alain, Ecosse Emmanuel, Coste Joel, Carel Jean-Claude
Université Paris Diderot, Sorbonne Paris Cité, Paris 75019, France.
Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris 75019, France.
J Clin Endocrinol Metab. 2017 Apr 1;102(4):1291-1298. doi: 10.1210/jc.2016-3145.
Growth hormone (GH) is known to be diabetogenic, but the risk of diabetes in individuals treated with GH in childhood has been little evaluated, and conflicting results have been obtained.
To investigate the prevalence of diabetes and gestational diabetes in a population-based cohort of patients treated with GH for short stature in childhood in France.
DESIGN, SETTING, AND PARTICIPANTS: Participants were a population-based cohort of 5100 children with idiopathic isolated GH deficiency, idiopathic short stature, or short stature in children born short for gestational age who started GH treatment between 1985 and 1996. Data on the delivery of diabetes drugs in 2009 and 2010 were obtained from the French national health insurance database. Cases in patients and controls were identified from diabetes drugs deliveries.
The prevalence of diabetes was calculated and compared with that in the general population, determined on the basis of data from the same source, with the same definition.
At a mean age of 30 years, no difference in the prevalence of treated diabetes (oral drugs or insulin) was found between subjects treated with GH and the general population in France, regardless of sex. Similarly, the risk of insulin-treated gestational diabetes was similar in patients and in the reference population.
No difference in the risk of diabetes was found between GH-treated patients and the reference population. These results are reassuring, but further studies with a longer follow-up are required to evaluate the risk of diabetes with age in these patients.
已知生长激素（GH）具有致糖尿病作用，但儿童期接受GH治疗的个体患糖尿病的风险鲜有评估，且结果相互矛盾。
调查法国以人群为基础的队列中，儿童期因身材矮小接受GH治疗的患者患糖尿病和妊娠糖尿病的患病率。
设计、地点和参与者：参与者是一个以人群为基础的队列，包括5100名患有特发性孤立性生长激素缺乏症、特发性身材矮小或小于胎龄儿出生后身材矮小的儿童，他们于1985年至1996年开始接受GH治疗。2009年和2010年糖尿病药物发放的数据来自法国国家健康保险数据库。通过糖尿病药物发放情况确定患者和对照中的病例。
计算糖尿病患病率，并与基于相同来源、相同定义的数据确定的普通人群患病率进行比较。
在平均年龄30岁时，无论性别，接受GH治疗的受试者与法国普通人群在接受治疗的糖尿病（口服药物或胰岛素）患病率方面未发现差异。同样，患者和参考人群中接受胰岛素治疗的妊娠糖尿病风险相似。
接受GH治疗的患者与参考人群在患糖尿病风险方面未发现差异。这些结果令人安心，但需要进行更长时间随访的进一步研究，以评估这些患者随着年龄增长患糖尿病 的风险。
