Kum Chang Dae, Rho Jung Gi, Park Hong Kyu, Lee Hae Sang, Hwang Jin Soon
Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Ann Pediatr Endocrinol Metab. 2021 Mar;26(1):31-37. doi: 10.6065/apem.2040096.048. Epub 2021 Mar 31.
Because small for gestational age (SGA) children who fail to experience catch-up growth have an increased risk of short stature in adulthood, growth hormone (GH) treatment is recommended for effective growth. In this study, we evaluated the effect of GH treatment during the prepubertal period and analyzed for correlation between GH treatment response and clinical factors in SGA children.
A retrospective, single-center study was conducted from 2014 to 2020. A total of 34 prepubertal children of short stature up to 4 years of age and born as SGA were enrolled. We recorded clinical data including birth data, age, weight, height, bone age (BA), and insulin-like growth factor 1 (IGF-1) levels.
The mean gestational age and birth weight were 37.50±2.51 weeks and 2,200.00±546.79 g. At the start of GH treatment, the mean chronological age and BA were 5.54±1.73 years and 4.52±1.85 years, respectively. The height standard deviation score (SDS) (-2.47±0.45) and IGF-1 SDS (0.16±1.57) were calculated. Height velocity was 9.43±1.40 cm during the first GH treatment year and 7.63±1.16 cm during the second year (P<0.05). The treatment growth response was positively correlated with young age (P=0.047) and lower BA (P=0.049) at the start of treatment. In multiple regression analysis, IGF-1 SDS change had a significantly positive association with GH treatment response (P=0.045).
GH treatment is effective for short stature SGA children who do not experience catch-up growth. Early initiation of GH treatment improved growth outcomes. As IGF-1 SDS is positively correlated with height SDS, IGF-1 monitoring is important during GH treatment of SGA prepubertal children.
由于未实现追赶生长的小于胎龄（SGA）儿童成年后身材矮小的风险增加，推荐使用生长激素（GH）治疗以实现有效生长。在本研究中，我们评估了青春期前阶段GH治疗的效果，并分析了SGA儿童GH治疗反应与临床因素之间的相关性。
进行了一项2014年至2020年的回顾性单中心研究。共纳入34名青春期前身材矮小、4岁及以下且为SGA出生的儿童。我们记录了包括出生数据、年龄、体重、身高、骨龄（BA）和胰岛素样生长因子1（IGF-1）水平在内的临床数据。
平均孕周和出生体重分别为37.50±2.51周和2200.00±546.79克。在开始GH治疗时，平均实足年龄和BA分别为5.54±1.73岁和4.52±1.85岁。计算了身高标准差评分（SDS）（-2.47±0.45）和IGF-1 SDS（0.16±1.57）。在GH治疗的第一年身高增长速度为9.43±1.40厘米，第二年为7.63±1.16厘米（P<0.05）。治疗生长反应与治疗开始时的低龄（P=0.047）和较低BA（P=0.049）呈正相关。在多元回归分析中，IGF-1 SDS变化与GH治疗反应呈显著正相关（P=0.045）。
GH治疗对未实现追赶生长的SGA身材矮小儿童有效。早期开始GH治疗可改善生长结局。由于IGF-1 SDS与身高SDS呈正相关，在SGA青春期前儿童的GH治疗期间监测IGF-1很重要。
