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[宫内生长迟缓所致身材矮小。临床及激素代谢特征、生长刺激治疗的可能性]

[Short stature due to intrauterine growth retardation. Clinical and hormonal-metabolic features, possibilities of growth-stimulating therapy].

作者信息

Nagaeva E V

机构信息

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2022 Oct 23;68(5):4-13. doi: 10.14341/probl13178.

Abstract

The article presents data about short stature due to intrauterine development delay. This type of short stature - separate nosology, unites children born small for gestation age. The majority of them in the first years of life have accelerated growth rates, allowing the child to normalize their weight-growth indicators and catch up in the development of peers. In the absence of an accelerated growth rates, children have a high risk of lagging behind in physical development throughout childhood, achieving low final growth and becoming short adults. In addition, the fact of birth with small body sizes is associated with a number of hormonal and metabolic features, a risk of metabolic syndrome in adult years.It is assumed that the absence of postnatal growth acceleration is due to various damages to the GH-IGF1 axis (partial GH deficiency, partial resistance to GH, partial resistance to IGF1). Growth hormone therapy, initiated early in life, is able to normalize growth rates in childhood and ultimately significantly improve or normalize the final growth of short stature children born small for gestational age.

摘要

本文介绍了因宫内发育迟缓导致身材矮小的数据。这种类型的身材矮小——作为一种独立的疾病分类,涵盖了出生时小于胎龄的儿童。他们中的大多数在生命的最初几年生长速度加快,使儿童能够使其体重增长指标正常化,并在同龄人发育中追赶上来。如果没有生长速度加快,儿童在整个童年期身体发育滞后、最终身高较低并成为矮个子成年人的风险就很高。此外,出生时身材小的情况与一些激素和代谢特征相关,成年后患代谢综合征的风险也高。据推测,出生后生长未加速是由于生长激素-胰岛素样生长因子1(GH-IGF1)轴受到各种损害(部分生长激素缺乏、部分生长激素抵抗、部分胰岛素样生长因子1抵抗)。在生命早期开始生长激素治疗,能够使儿童期生长速度正常化,并最终显著改善或使小于胎龄出生的身材矮小儿童的最终身高正常化。

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本文引用的文献

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Intrauterine growth restriction and later cardiovascular function.宫内生长受限与后期心血管功能
Early Hum Dev. 2018 Nov;126:23-27. doi: 10.1016/j.earlhumdev.2018.08.013. Epub 2018 Sep 8.
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Fetal growth restriction in twins.双胎胎儿生长受限。
Best Pract Res Clin Obstet Gynaecol. 2018 May;49:79-88. doi: 10.1016/j.bpobgyn.2018.02.004. Epub 2018 Feb 24.
9
Pathophysiology of placental-derived fetal growth restriction.胎盘源性胎儿生长受限的病理生理学。
Am J Obstet Gynecol. 2018 Feb;218(2S):S745-S761. doi: 10.1016/j.ajog.2017.11.577.

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