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孤立性生长激素缺乏所致严重身材矮小成人的步行与姿势平衡

Walking and postural balance in adults with severe short stature due to isolated GH deficiency.

作者信息

Santana-Ribeiro Ananda A, Moreira-Brasileiro Giulliani A, Aguiar-Oliveira Manuel H, Salvatori Roberto, Carvalho Vitor O, Alvim-Pereira Claudia K, Araújo-Daniel Carlos R, Reis-Costa Júlia G, Andrade-Guimarães Alana L, Oliveira-Santos Alécia A, Vieira Edgar R, Gois-Junior Miburge B

机构信息

Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil.

Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil.

出版信息

Endocr Connect. 2019 Apr;8(4):416-424. doi: 10.1530/EC-19-0103.

Abstract

OBJECTIVES

Walking and postural balance are extremely important to obtain food and to work. Both are critical for quality of life and ability to survive. While walking reflects musculoskeletal and cardiopulmonary systems, postural balance depends on body size, muscle tone, visual, vestibular and nervous systems. Since GH and IGF-I act on all these systems, we decided to study those parameters in a cohort of individuals with severe short stature due to untreated isolated GH deficiency (IGHD) caused by a mutation in the GHRH receptor gene. These IGHD subjects, despite reduction in muscle mass, are very active and have normal longevity.

METHODS

In a cross-sectional study, we assessed walking (by a 6-min walk test), postural balance (by force platform) and fall risk (by the 'Timed Up and Go' test) in 31 IGHD and 40 matched health controls.

RESULTS

The percentage of the walked distance measured in relation to the predicted one was similar in groups, but higher in IGHD, when corrected by the leg length. Absolute postural balance data showed similar velocity of unipodal support in the two groups, and better values, with open and closed eyes and unipodal support, in IGHD, but these differences became non-significant when corrected for height and lower-limb length. The time in 'Timed Up and Go' test was higher in IGHD cohort, but still below the cut-off value for fall risk.

CONCLUSION

IGHD subjects exhibit satisfactory walking and postural balance, without increase in fall risk.

摘要

目的

行走和姿势平衡对于获取食物和工作极为重要。二者对于生活质量和生存能力都至关重要。行走反映了肌肉骨骼系统和心肺系统,而姿势平衡则取决于体型、肌张力、视觉、前庭和神经系统。由于生长激素(GH)和胰岛素样生长因子-I(IGF-I)作用于所有这些系统,我们决定在一组因生长激素释放激素(GHRH)受体基因突变导致未经治疗的孤立性生长激素缺乏症(IGHD)而身材严重矮小的个体中研究这些参数。这些IGHD受试者尽管肌肉量减少,但非常活跃且寿命正常。

方法

在一项横断面研究中,我们评估了31名IGHD患者和40名匹配的健康对照者的行走能力(通过6分钟步行试验)、姿势平衡(通过测力平台)和跌倒风险(通过“从坐到站”试验)。

结果

按预测距离测量的行走距离百分比在两组中相似,但经腿长校正后,IGHD组更高。绝对姿势平衡数据显示,两组单足支撑的速度相似,且IGHD组在睁眼、闭眼和单足支撑时的值更好,但经身高和下肢长度校正后,这些差异变得不显著。IGHD队列中“从坐到站”试验的时间更长,但仍低于跌倒风险的临界值。

结论

IGHD受试者表现出令人满意的行走和姿势平衡,且跌倒风险未增加。

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