Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Growth Horm IGF Res. 2023 Apr-Jun;69-70:101531. doi: 10.1016/j.ghir.2023.101531. Epub 2023 Feb 24.
Growth hormone (GH) dosage in children is conventionally determined either by body weight (BW) or body surface area (BSA). However, there is no consensus on the calculation method for proper GH treatment dose. We aimed to compare growth response and adverse reactions between BW- and BSA-based GH treatment doses for children with short statures.
Data from 2284 GH-treated children were analyzed. Distributions of BW- and BSA-based GH treatment doses and their association with growth response parameters, including changes in height, height standard deviation score (SDS), body mass index (BMI), and safety parameters, such as changes in insulin-like growth factor (IGF)-I SDS and adverse events, were investigated.
The mean BW-based doses were close to the recommended dose's upper limit in participants with GH deficiency and idiopathic short stature, while they were below the recommended dose in patients with Turner syndrome (TS). As age and BW increased, BW-based dose decreased, whereas BSA-based dose increased. Gain in height SDS was positively associated with BW-based dose in the TS group and negatively associated with BW in all groups. Despite having a lower BW-based dose, the overweight/obese groups had a higher BSA-based dose and higher frequencies of children with high IGF-I and adverse events than those of the normal-BMI group.
In children of older age or with high BW, BW-based doses can be overdosed in terms of BSA. and BW-based dose positively correlated with height gain only in the TS group. BSA-based doses represent an alternative dosing strategy in children who are overweight/obese.
儿童生长激素（GH）剂量通常根据体重（BW）或体表面积（BSA）来确定。然而，对于合适的 GH 治疗剂量的计算方法尚未达成共识。我们旨在比较基于 BW 和 BSA 的 GH 治疗剂量对矮小儿童的生长反应和不良反应。
分析了 2284 名接受 GH 治疗的儿童的数据。研究了基于 BW 和 BSA 的 GH 治疗剂量的分布及其与生长反应参数（包括身高变化、身高标准差评分（SDS）、体重指数（BMI））的关系，以及安全性参数（如胰岛素样生长因子（IGF）-I SDS 和不良反应的变化）。
在 GH 缺乏症和特发性身材矮小患者中，平均 BW 剂量接近推荐剂量上限，而在 Turner 综合征（TS）患者中则低于推荐剂量。随着年龄和 BW 的增加，BW 剂量降低，而 BSA 剂量增加。身高 SDS 的增加与 TS 组的 BW 剂量呈正相关，与所有组的 BW 呈负相关。尽管 BW 剂量较低，但超重/肥胖组的 BSA 剂量较高，且 IGF-I 高和不良反应的儿童频率高于正常 BMI 组。
在年龄较大或 BW 较高的儿童中，BSA 方面 BW 剂量可能过量。BW 剂量仅与 TS 组的身高增加呈正相关。BSA 剂量代表了超重/肥胖儿童的替代给药策略。
