Isojima Tsuyoshi, Hasegawa Tomonobu, Yokoya Susumu, Tanaka Toshiaki
Growth Hormone (GH) and its related Factors Study Committee and GH Treatment Study Committee, The Foundation for Growth Science in Japan, Tokyo, Japan.
Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Endocr J. 2017 Sep 30;64(9):851-858. doi: 10.1507/endocrj.EJ17-0063. Epub 2017 Jul 4.
Growth hormone (GH) treatment for children with GH deficiency (GHD) is effective in improving adult height. To achieve favorable effects, GH treatment before puberty is very important, because prepubertal height gain is highly correlated with total height gain. However, no report has studied the effects by analyzing a nationwide data from recent GHD patients in Japan. We investigated the response to GH treatment using data compiled in the Foundation for Growth Science in Japan, and compared the effects between the 1990s and 2000s using analysis of covariance. We analyzed 534 prepubertal GHD subjects treated in the 2000s with three consecutive years of data from the start and investigated predictive factors for the effects. The cumulative height standard deviation score (SDS) change over three years of GH treatment was 0.91 ± 0.57 and 1.20 ± 0.62 in the 1990s and 2000s, respectively. Subjects in the 2000s were divided into three groups by severity, and the cumulative height SDS was 1.60 ± 0.93, 1.20 ± 0.54, and 1.00 ± 0.40 indicating severe, moderate, and mild GHD, respectively. Age and height SDS at the start and severity were identified as independent predictive factors. We also found a significant difference in the effects between the two cohorts after adjusting for the different factors (regression coefficient: -0.069, 95% confidence interval: -0.11 to -0.030, p = 0.0006), which might be due to the GH dose effect. We conclude that the effects of GH treatment in the 2000s had improved compared with those in the 1990s.
生长激素(GH)治疗生长激素缺乏症(GHD)儿童对提高成人身高有效。为取得良好效果,青春期前进行GH治疗非常重要,因为青春期前身高增长与总身高增长高度相关。然而,尚无报告通过分析日本近期GHD患者的全国性数据来研究其效果。我们利用日本生长科学基金会汇编的数据调查了对GH治疗的反应,并使用协方差分析比较了20世纪90年代和21世纪00年代的效果。我们分析了21世纪00年代接受治疗的534名青春期前GHD受试者,从开始治疗起连续三年的数据,并研究了效果的预测因素。20世纪90年代和21世纪00年代,GH治疗三年期间累积身高标准差评分(SDS)变化分别为0.91±0.57和1.20±0.62。21世纪00年代的受试者按严重程度分为三组,累积身高SDS分别为1.60±0.93、1.20±0.54和1.00±0.40,分别表示重度、中度和轻度GHD。开始治疗时的年龄和身高SDS以及严重程度被确定为独立预测因素。我们还发现,在调整不同因素后,两个队列之间的效果存在显著差异(回归系数:-0.069,95%置信区间:-0.11至-0.030,p = 0.0006),这可能是由于GH剂量效应。我们得出结论,与20世纪90年代相比,21世纪00年代GH治疗的效果有所改善。