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生长激素缺乏症的评分设计与治疗效果(GET)评分及非干预性概念验证研究。

Design of the Growth hormone deficiency and Efficacy of Treatment (GET) score and non-interventional proof of concept study.

作者信息

Kann Peter H, Bergmann Simona, Bidlingmaier Martin, Dimopoulou Christina, Pedersen Birgitte T, Stalla Günter K, Weber Matthias M, Meckes-Ferber Stefanie

机构信息

Division of Endocrinology & Diabetology, Philipp's University Marburg, D-35033, Marburg, Germany.

Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians University, 80336, Munich, Germany.

出版信息

BMC Endocr Disord. 2018 Feb 13;18(1):10. doi: 10.1186/s12902-018-0237-3.

Abstract

BACKGROUND

The adverse effects of growth hormone (GH) deficiency (GHD) in adults (AGHD) on metabolism and health-related quality of life (HRQoL) can be improved with GH substitution. This investigation aimed to design a score summarising the features of GHD and evaluate its ability to measure the effect of GH substitution in AGHD.

METHODS

The Growth hormone deficiency and Efficacy of Treatment (GET) score (0-100 points) assessed (weighting): HRQoL (40%), disease-related days off work (10%), bone mineral density (20%), waist circumference (10%), low-density lipoprotein cholesterol (10%) and body fat mass (10%). A prospective, non-interventional, multicentre proof-of-concept study investigated whether the score could distinguish between untreated and GH-treated patients with AGHD. A 10-point difference in GET score during a 2-year study period was expected based on pre-existing knowledge of the effect of GH substitution in AGHD.

RESULTS

Of 106 patients eligible for analysis, 22 were untreated GHD controls (9 females, mean ± SD age 52 ± 17 years; 13 males, 57 ± 13 years) and 84 were GH-treated (31 females, age 45 ± 13 years, GH dose 0.30 ± 0.16 mg/day; 53 males, age 49 ± 15 years, GH dose 0.25 ± 0.10 mg/day). Follow-up was 706 ± 258 days in females and 653 ± 242 days in males. The GET score differed between the untreated control and treated groups with a least squares mean difference of + 10.01 ± 4.01 (p = 0.0145).

CONCLUSIONS

The GET score appeared to be a suitable integrative instrument to summarise the clinical features of GHD and measure the effects of GH substitution in adults. Exercise capacity and muscle strength/body muscle mass could be included in the GET score.

TRIAL REGISTRATION

NCT number: NCT00934063 . Date of registration: 02 July 2009.

摘要

背景

生长激素(GH)缺乏症(GHD)对成人(AGHD)的代谢及健康相关生活质量(HRQoL)的不良影响可通过GH替代治疗得到改善。本研究旨在设计一个评分系统,总结GHD的特征,并评估其测量AGHD中GH替代治疗效果的能力。

方法

生长激素缺乏症及治疗效果(GET)评分(0 - 100分)评估(加权):HRQoL(40%)、因病缺勤天数(10%)、骨密度(20%)、腰围(10%)、低密度脂蛋白胆固醇(10%)和体脂量(10%)。一项前瞻性、非干预性、多中心概念验证研究调查了该评分是否能区分未接受治疗和接受GH治疗的AGHD患者。基于此前关于AGHD中GH替代治疗效果的认识,预计在为期2年的研究期间GET评分会有10分的差异。

结果

106例符合分析条件的患者中,22例为未接受治疗的GHD对照(9例女性,平均±标准差年龄52±17岁;13例男性,57±13岁),84例接受GH治疗(31例女性,年龄45±13岁,GH剂量0.30±0.16mg/天;53例男性,年龄49±15岁,GH剂量0.25±0.10mg/天)。女性随访时间为706±258天,男性为653±242天。未治疗对照组和治疗组的GET评分存在差异,最小二乘均值差异为 + 10.01±4.01(p = 0.0145)。

结论

GET评分似乎是一个合适的综合工具,可用于总结GHD的临床特征并测量成人中GH替代治疗的效果。运动能力和肌肉力量/身体肌肉量可纳入GET评分。

试验注册

NCT编号:NCT00934063。注册日期:2009年7月2日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d0/5810096/a83b7ef5622e/12902_2018_237_Fig1_HTML.jpg

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