Im Minji, Kim Yong-Dae, Han Heon-Seok
Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Preventive Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Ann Pediatr Endocrinol Metab. 2017 Jun;22(2):119-124. doi: 10.6065/apem.2017.22.2.119. Epub 2017 Jun 28.
There are inconsistencies in the results reported in a small number of previous studies into growth hormone (GH) treatment in Korean children with idiopathic short stature (ISS) and idiopathic growth hormone deficiency (IGHD). Thus, the authors retrospectively compared the effects of GH in ISS and IGHD.
From the medical records of 26 ISS and 30 IGHD children, auxological and biochemical changes including chronologic age (CA), bone age (BA), height standard deviation score (HT-SDS), predicted adult height (PAH), midparental height (MPH), insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-3 (IGFBP-3) were compared.
Before treatment, IGHD group had younger BA, lower BA/CA ratio, and lower IGF-1 level than those in the ISS group. During GH treatment, the levels of IGF-1 and IGFBP-3 were not different. Although annual BA increment was higher in IGHD group, and annual PAH-SDS increment was higher in ISS group, annual HT-SDS increments were not different. Both HT-SDS and PAH-SDS in the ISS group increased significantly until the end of the second year, and then those were not significantly different from MPH-SDS. In the IGHD group, the HT-SDS showed a significant increase till the end of the second year, and the PAH-SDS was not significantly changed at each year, but both HT-SDS and PAH-SDS were not significantly different from MPH-SDS at the end of the third year.
During GH treatment, both HT-SDS and PAH-SDS approached the genetic target range of MPH-SDS after 2 years in ISS children and 3 years in IGHD children.
此前少数针对韩国特发性矮小（ISS）和特发性生长激素缺乏症（IGHD）儿童进行生长激素（GH）治疗的研究报告结果存在不一致性。因此，作者回顾性比较了GH对ISS和IGHD的治疗效果。
从26例ISS儿童和30例IGHD儿童的病历中，比较了包括实足年龄（CA）、骨龄（BA）、身高标准差评分（HT-SDS）、预测成人身高（PAH）、父母平均身高（MPH）、胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）在内的体格学和生化指标变化。
治疗前，IGHD组的BA较年轻，BA/CA比值较低，IGF-1水平低于ISS组。在GH治疗期间，IGF-1和IGFBP-3水平无差异。虽然IGHD组的年BA增加值较高，ISS组的年PAH-SDS增加值较高，但年HT-SDS增加值无差异。ISS组的HT-SDS和PAH-SDS在第二年年底前均显著增加，之后与MPH-SDS无显著差异。在IGHD组，HT-SDS在第二年年底前显著增加，PAH-SDS每年无显著变化，但在第三年年底时HT-SDS和PAH-SDS与MPH-SDS均无显著差异。
在GH治疗期间，ISS儿童在2年后、IGHD儿童在3年后，HT-SDS和PAH-SDS均接近MPH-SDS的遗传目标范围。
