Greene S A, Torresani T, Prader A
Arch Dis Child. 1987 Jan;62(1):53-6. doi: 10.1136/adc.62.1.53.
Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9 (1.4) years; mean height SDS 3.0 (0.8], and 30 normal children (group 3: mean age 13.3 (3.2) years; mean bone age 12.8 (3.4) years; mean height SDS -0.4 (0.8]. Results of GH are expressed as mean (SEM). The pre-exercise GH was similar in the three groups (group 1, 8.0 (2.3) mU/l, group 2, 8.5 (2.5) mU/l, and group 3, 8.3 (2.3) mU/l). There was a significant rise in GH after exercise in all three groups. GH after exercise was higher in group 2 (35.1 (2.5) mU/l) compared with groups 1 and 3 (17.8 (3.0) and (20.8 (3.2) mU/l). Post-exercise GH was less than 10 mU/l in 29 children (34% total; 49% group 1, 6% group 2, and 34% group 3). There was a positive relation between post-exercise GH and both bone age and public hair stage. Multiple regression analysis revealed that relevant predictors of a rise in GH with exercise were different for the sexes in these children with varying stature: for boys, bone age and pubic hair stage; for girls, height and height SDS. All the tall girls were in puberty. No statistical relation was observed between post-experience GH and cardiovascular response to exercise, time of day of exercise, time of eating before exercise, and plasma insulin or insulin to glucose ratio at time of exercise. We conclude that the GH response to the physiological stimulus of exercise is higher in puberty compared with childhood. Therefore, although children may be suspected of having GH deficiency after a failure of GH to increase after exercise, a non-response may be a normal finding in prepubertal children, independent of stature.
在37名身材矮小儿童(第1组:平均(标准差)年龄12.8(3.5)岁;平均(标准差)骨龄10.4(3.6)岁;平均(标准差)身高标准差评分(SDS)-2.8(0.7))、16名身材高大儿童(第2组:平均年龄12.9(2.8)岁;平均骨龄13.9(1.4)岁;平均身高SDS 3.0(0.8))和30名正常儿童(第3组:平均年龄13.3(3.2)岁;平均骨龄12.8(3.4)岁;平均身高SDS -0.4(0.8))中,于标准化自行车运动试验(持续15分钟)前及运动后10分钟测量生长激素(GH)。GH结果以平均(标准误)表示。三组运动前GH相似(第1组,8.0(2.3)mU/l;第2组,8.5(2.5)mU/l;第3组,8.3(2.3)mU/l)。三组运动后GH均显著升高。与第1组和第3组(分别为17.8(3.0)和20.8(3.2)mU/l)相比,第2组运动后GH更高(35.1(2.5)mU/l)。29名儿童运动后GH低于10 mU/l(占总数的34%;第1组占49%,第2组占6%,第3组占34%)。运动后GH与骨龄和阴毛分期均呈正相关。多元回归分析显示,在这些不同身材的儿童中,运动后GH升高的相关预测因素因性别而异:对于男孩,是骨龄和阴毛分期;对于女孩,是身高和身高SDS。所有身材高大的女孩均处于青春期。未观察到运动后GH与运动的心血管反应、运动时间、运动前进食时间以及运动时血浆胰岛素或胰岛素与葡萄糖比值之间存在统计学关联。我们得出结论,与儿童期相比,青春期对运动这种生理刺激的GH反应更高。因此,尽管儿童在运动后GH未能升高可能被怀疑患有GH缺乏症,但无反应在青春期前儿童中可能是正常现象,与身材无关。