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特发性生长激素缺乏症和特发性身材矮小患者在生长激素治疗3年期间影响骨龄成熟的因素:来自LG生长研究的数据分析

Factors affecting bone age maturation during 3 years of growth hormone treatment in patients with idiopathic growth hormone deficiency and idiopathic short stature: Analysis of data from the LG growth study.

作者信息

Kang Min Jae, Kim Eun Young, Shim Young Suk, Jeong Hwal Rim, Lee Hye Jin, Yang Seung, Hwang Il Tae

机构信息

Department of Pediatrics, Hallym University College of Medicine, Chuncheon-si, Gangwon-do.

Life Science R&D, LG Chem, Ltd., Gangseo-gu, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2019 Apr;98(14):e14962. doi: 10.1097/MD.0000000000014962.

Abstract

To investigate the progression rate of bone age (BA) and associated factors during the first 3 years of growth hormone (GH) treatment in children with idiopathic GH deficiency (iGHD) and idiopathic short stature (ISS).Data for prepubertal children with iGHD and ISS who were treated with recombinant human GH were obtained from the LG Growth Study Database and analyzed. Height, weight, BA, insulin-like growth factor-1 (IGF-1) level, and GH dose were recorded every 6 months. Differences between BA and chronological age (CA), BA-CA, were calculated at each measurement. This study included 92 (78 iGHD and 14 ISS) subjects.After 3 years of GH treatment, the height z-score was -1.09 ± 0.71 (P < .001 compared to baseline), BA-CA was -1.21 ± 1.18 years (P < .001), and IGF-1 standard deviation score (SDS) was 0.43 ± 1.21 (P < .001) in the iGHD subjects; the change in BA over the 3 years was 3.68 ± 1.27 years. In the ISS subjects, the height z-score was -1.06 ± 0.59 (P < .001), BA-CA was -0.98 ± 1.23 years (P = .009), and IGF-1 SDS was 0.16 ± 0.76 (P = .648); the change in BA over the 3 years was 3.88 ± 1.36 years. The only significant factor associated with the BA progression was the BA-CA at 1 year of GH treatment (OR = 2.732, P = .001). The baseline BA-CA, IGF-1 SDS, and GH dose did not influence BA progression.Prepubertal subjects with iGHD and ISS showed height improvement and mild BA acceleration over the first 3 years of GH treatment. However, because the BA progression rate was considered to be clinically acceptable, GH treatment may increase the predicted adult height during this period.

摘要

研究特发性生长激素缺乏症(iGHD)和特发性身材矮小(ISS)儿童在生长激素(GH)治疗的前3年中骨龄(BA)的进展速度及相关因素。从LG生长研究数据库中获取接受重组人生长激素治疗的青春期前iGHD和ISS儿童的数据并进行分析。每6个月记录身高、体重、BA、胰岛素样生长因子-1(IGF-1)水平和GH剂量。每次测量时计算BA与实际年龄(CA)的差值,即BA-CA。本研究纳入了92名受试者(78名iGHD和14名ISS)。GH治疗3年后,iGHD受试者的身高z评分是-1.09±0.71(与基线相比,P<0.001),BA-CA为-1.21±1.18岁(P<0.001),IGF-1标准差评分(SDS)为0.43±1.21(P<0.001);3年期间BA的变化为3.68±1.27岁。在ISS受试者中,身高z评分为-1.06±0.59(P<0.001),BA-CA为-0.98±1.23岁(P=0.009),IGF-1 SDS为0.16±0.76(P=0.648);3年期间BA的变化为3.88±1.36岁。与BA进展相关的唯一显著因素是GH治疗1年时的BA-CA(比值比=2.732,P=0.001)。基线BA-CA、IGF-1 SDS和GH剂量均不影响BA进展。青春期前iGHD和ISS受试者在GH治疗的前3年中身高有所改善,骨龄有轻度加速。然而,由于骨龄进展速度被认为在临床上是可接受的,在此期间GH治疗可能会增加预测的成人身高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1e0/6456092/05a19ae5ba13/medi-98-e14962-g002.jpg

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