Majewska Katarzyna Anna, Tchorzewska-Skrobich Magdalena, Wais Paulina, Majewski Dominik, Naskręcka Monika, Kędzia Andrzej
Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
Department of Internal Medicine, Poznan University of Medical Sciences, 60-780 Poznan, Poland.
Biomedicines. 2024 Jul 26;12(8):1673. doi: 10.3390/biomedicines12081673.
Short stature affects approximately 2.5% of children. Some of them, when diagnosed with growth hormone deficiency (GHD), benefit from recombinant human growth hormone (rhGH) therapy; in others, this treatment is controversial. We aimed to present the clinical characteristics of Polish short stature children in the context of current GHD diagnostic standards, as obtaining more data gives a broader foundation for the potential modifications of diagnostic and therapeutic recommendations. This retrospective analysis was based on a cohort of 277 short stature children divided into two subgroups depending on their peak growth hormone (GH) cutoff level, set at 10 ng/mL: 138 had growth hormone deficiency (GHD) and 137 had normal growth hormone secretion (GHN). These subgroups were then compared based on the extracted clinical data. In the obtained result, no significant differences between the GHD and GHN subgroups were found in any of the variables, including the following: gender distribution, birth weight, bone age delay, height SDS, IGF-1 SDS, vitamin D levels, celiac disease indices, prevalence of hypothyroidism or anemia. As our results point to major clinical similarities between the GHD and GHN children, it seems that distinguishing patients with normal GH secretion from those with deficient GH secretion based on a 10 ng/mL cutoff value might not be clinically relevant.
身材矮小影响约2.5%的儿童。其中一些被诊断为生长激素缺乏症(GHD)的儿童受益于重组人生长激素(rhGH)治疗;而对于其他儿童,这种治疗存在争议。我们旨在根据当前的GHD诊断标准,呈现波兰身材矮小儿童的临床特征,因为获取更多数据可为诊断和治疗建议的潜在修改提供更广泛的基础。这项回顾性分析基于一组277名身材矮小儿童,根据其生长激素(GH)峰值临界水平分为两个亚组,临界水平设定为10 ng/mL:138名患有生长激素缺乏症(GHD),137名生长激素分泌正常(GHN)。然后根据提取的临床数据对这些亚组进行比较。在所得结果中,GHD和GHN亚组在任何变量上均未发现显著差异,包括以下方面:性别分布、出生体重、骨龄延迟、身高标准差分数(SDS)、胰岛素样生长因子-1(IGF-1)SDS、维生素D水平、乳糜泻指标、甲状腺功能减退或贫血的患病率。由于我们的结果表明GHD和GHN儿童在主要临床特征上相似,基于10 ng/mL临界值区分生长激素分泌正常的患者和生长激素分泌不足的患者在临床上可能并不相关。