Department of Endocrinology, Shanghai Tenth People's Hospital, Shanghai, China.
Department of Endocrinology, Ningbo Women and Children's Hospital, Ningbo, China.
Pediatr Res. 2018 May;83(5):954-960. doi: 10.1038/pr.2017.271. Epub 2018 Jan 17.
BackgroundReports on the association between growth hormone deficiency (GHD) and cardiovascular risk factors in children are limited. We aim to investigate the effect of different doses of recombinant human growth hormone (rhGH) therapy on blood lipid and carotid intima-media thickness (cIMT) in Chinese GHD children.MethodsNinety children, including sixty isolated GHD children and thirty healthy children, were enrolled. GHD children were randomly divided into two groups (A and B) according to the rhGH dose given: group A received 0.23 mg/kg/week and group B received 0.35 mg/kg/week for 12 months. The TC, TG, LDL-C, HDL-C, and cIMT at baseline and after treatment were measured.ResultsThe height, weight, and height velocity improved significantly over 12 months of rhGH therapy in all GHD children. At baseline, GHD children in both the treatment groups showed significantly higher total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), cIMT, and lower high-density lipoprotein-cholesterol (HDL-C) than healthy children (all P≤0.033). After the 12-month rhGH therapy, a significant decrease in the TC, TG, LDL-C, and cIMT, as well as a significant increase in the HDL-C (P≤0.046), was observed in the GHD children, with change in the group B being even more marked.ConclusionsThe RhGH replacement therapy in GHD children can improve both the blood lipid profile and carotid intima-media thickness, with higher-dose rhGH therapy showing superior effects.
关于生长激素缺乏症（GHD）与儿童心血管危险因素之间关联的报告有限。我们旨在研究不同剂量重组人生长激素（rhGH）治疗对中国 GHD 儿童血脂和颈动脉内膜中层厚度（cIMT）的影响。
共纳入 90 名儿童，包括 60 例单纯 GHD 儿童和 30 例健康儿童。根据给予的 rhGH 剂量，GHD 儿童随机分为两组（A 和 B）：A 组接受 0.23mg/kg/周，B 组接受 0.35mg/kg/周，治疗 12 个月。测量基线和治疗后 TC、TG、LDL-C、HDL-C 和 cIMT。
所有 GHD 儿童在 rhGH 治疗 12 个月后身高、体重和身高增长速度均显著改善。基线时，两组治疗中的 GHD 儿童 TC、TG、LDL-C、cIMT 均明显高于健康儿童（均 P≤0.033），HDL-C 明显低于健康儿童（均 P≤0.033）。经过 12 个月的 rhGH 治疗后，GHD 儿童的 TC、TG、LDL-C 和 cIMT 显著降低，HDL-C 显著升高（均 P≤0.046），B 组的变化更为显著。
rhGH 替代治疗可改善 GHD 儿童的血脂谱和颈动脉内膜中层厚度，高剂量 rhGH 治疗效果更优。
