Department of Pediatrics, General Hospital of Ningxia Medical Univeristy, Yinchuan, China.
Department of Endocrinology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Front Endocrinol (Lausanne). 2021 Nov 29;12:726172. doi: 10.3389/fendo.2021.726172. eCollection 2021.
We performed a meta-analysis to evaluate the efficacy and safety of weekly long-acting growth hormone replacement therapy compared to daily growth hormone in children with short stature.
A systematic literature search up to April 2021 was performed and 11 studies included 1,232 children with short stature treated with growth hormone replacement therapy at the start of the study; 737 of them were using weekly long-acting growth hormone replacement therapy and 495 were using daily growth hormone. They were reporting relationships between the efficacy and safety of long-acting growth hormone replacement therapy and daily growth hormone in children with short stature. We calculated the odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) to assess the efficacy and safety of weekly long-acting growth hormone replacement therapy compared to daily growth hormone in children with short stature using the dichotomous or continuous method with a random or fixed-effect model.
Long-acting growth hormone replacement therapy had significantly lower height standard deviation scores chronological age (MD, -0.10; 95% CI, -0.13 to -0.08, p <0.001), and insulin-like growth factor binding protein-3 (MD, -0.69; 95% CI, -1.09 to -0.30, p <0.001) compared to daily growth hormone in children with short stature.However, growth hormone replacement therapy had no significantly difference in height velocity (MD, -0.09; 95% CI, -0.69-0.5, p = 0.76), height standard deviation scores bone age (MD, -0.04; 95% CI, -0.10-0.02, p = 0.16), insulin-like growth factor 1 standard deviation scores (MD, 0.26; 95% CI, -0.26-0.79, p = 0.33), and incidence of adverse events (OR, 1.16; 95% CI, 0.90-1.50, p = 0.25) compared to daily growth hormone in children with short stature.
Long-acting growth hormone replacement therapy had significantly lower height standard deviation scores chronological age, and insulin-like growth factor binding protein-3 compared to daily growth hormone in children with short stature. However, growth hormone replacement therapy had no significant difference in height velocity, height standard deviation scores bone age, insulin-like growth factor 1 standard deviation scores, and incidence of adverse events compared to daily growth hormone in children with short stature. Further studies are required to validate these findings.
我们进行了一项荟萃分析，以评估与每日生长激素相比，每周长效生长激素替代疗法在身材矮小儿童中的疗效和安全性。
系统检索截至 2021 年 4 月的文献，纳入 11 项研究，共纳入 1232 例起始治疗时使用生长激素替代疗法的身材矮小儿童；其中 737 例使用每周长效生长激素替代疗法，495 例使用每日生长激素。他们报告了长效生长激素替代疗法和每日生长激素在身材矮小儿童中的疗效和安全性之间的关系。我们使用二分类或连续方法，随机或固定效应模型，计算比值比（OR）和均数差值（MD）及其 95%置信区间（CI），以评估每周长效生长激素替代疗法与每日生长激素相比在身材矮小儿童中的疗效和安全性。
与每日生长激素相比，长效生长激素替代疗法使身材矮小儿童的身高标准差评分更差（MD，-0.10；95%CI，-0.13 至-0.08，p<0.001）和胰岛素样生长因子结合蛋白-3（MD，-0.69；95%CI，-1.09 至-0.30，p<0.001）。然而，生长激素替代疗法在身高速度（MD，-0.09；95%CI，-0.69 至 0.5，p=0.76）、骨龄身高标准差评分（MD，-0.04；95%CI，-0.10 至 0.02，p=0.16）、胰岛素样生长因子 1 标准差评分（MD，0.26；95%CI，-0.26 至 0.79，p=0.33）和不良事件发生率（OR，1.16；95%CI，0.90 至 1.50，p=0.25）方面与每日生长激素相比均无显著差异。
与每日生长激素相比，每周长效生长激素替代疗法在身材矮小儿童中可显著降低身高标准差评分更差，胰岛素样生长因子结合蛋白-3。然而，生长激素替代疗法在身高速度、骨龄身高标准差评分、胰岛素样生长因子 1 标准差评分和不良事件发生率方面与每日生长激素相比无显著差异。需要进一步的研究来验证这些发现。
