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大剂量重组人生长激素治疗对特发性矮小症学龄儿童血清维生素D和胰岛素样生长因子-1水平的影响分析

Analysis of the Influence of High-Dose rhGH Therapy on Serum Vitamin D and IGF-1 Levels in School-Age Children with Idiopathic Short Stature.

作者信息

Li Juan, Zhang Xuehui, Xie Shuyong, Feng Shuangshuang, Niu Min

机构信息

Endocrine Department, Anhui Fuyang People's Hospital, Fuyang, Anhui 236000, China.

出版信息

Evid Based Complement Alternat Med. 2021 Oct 26;2021:5776487. doi: 10.1155/2021/5776487. eCollection 2021.

Abstract

OBJECTIVE

To discuss the influence of high-dose recombinant human growth hormone (rhGH) therapy on serum vitamin D and insulin-like growth factor-1 (IGF-1) levels in school-age children with idiopathic short stature (ISS).

METHOD

A total of 103 school-age children with ISS were selected from June 2016 to June 2020 in our hospital. The enrolled cases were divided into the low-dose group ( = 59) and high-dose group ( = 44) according to the treatment dose of rhGH. After the treatment, the height (Ht), height standard deviation score (Ht SDS), growth velocity (GV), and other indicators were recorded. The serum 25-hydroxy vitamin D [25-(OH)D] and IGF-1 levels of the two groups were tested, and the occurrence of adverse reactions was recorded.

RESULTS

After treatment, the high-dose group outperformed the low-dose group in various growth effect indicators such as Ht, Ht SDS, and GV ( < 0.05). After treatment, the serum 25-(OH)D of children with ISS in the two groups increased significantly, but there was no significant difference between the two groups ( > 0.05). After treatment, the serum IGF-1 of children with ISS in the two groups increased significantly, but there was no significant difference between the two groups ( > 0.05). For children with ISS, adverse reactions induced by rhGH therapy were very rare. There was no significant difference in the incidence of adverse reactions induced by different doses of rhGH in the treatment of ISS ( > 0.05).

CONCLUSION

rhGH has definite efficacy in the treatment of ISS children, for it can significantly increase the annual growth rate of ISS children in a dose-dependent manner. High-dose rhGH for ISS has a better therapeutic effect. At the same time, regardless of the dose level of rhGH, serum 25-(OH)D and IGF-1 levels in children with ISS were increased, with less adverse reactions and higher safety.

摘要

目的

探讨大剂量重组人生长激素(rhGH)治疗对特发性矮小(ISS)学龄儿童血清维生素D及胰岛素样生长因子-1(IGF-1)水平的影响。

方法

选取2016年6月至2020年6月我院收治的103例ISS学龄儿童。根据rhGH治疗剂量将入选病例分为低剂量组(n = 59)和高剂量组(n = 44)。治疗后,记录身高(Ht)、身高标准差评分(Ht SDS)、生长速度(GV)等指标。检测两组患儿血清25-羟基维生素D [25-(OH)D]及IGF-1水平,并记录不良反应发生情况。

结果

治疗后,高剂量组在Ht、Ht SDS、GV等各项生长效应指标上均优于低剂量组(P < 0.05)。治疗后,两组ISS患儿血清25-(OH)D均显著升高,但两组间差异无统计学意义(P > 0.05)。治疗后,两组ISS患儿血清IGF-1均显著升高,但两组间差异无统计学意义(P > 0.05)。对于ISS患儿,rhGH治疗引起的不良反应非常罕见。不同剂量rhGH治疗ISS时不良反应发生率差异无统计学意义(P > 0.05)。

结论

rhGH治疗ISS患儿疗效确切,能以剂量依赖方式显著提高ISS患儿的年生长速率。大剂量rhGH治疗ISS疗效更佳。同时,无论rhGH剂量水平如何,ISS患儿血清25-(OH)D和IGF-1水平均升高,不良反应较少,安全性较高。

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