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比利时将儿童期起病的生长激素缺乏症从儿科内分泌护理过渡到成人内分泌护理的政策。

Policy for transitioning childhood-onset growth hormone deficiency from pediatric to adult endocrine care in Belgium.

机构信息

Division of Pediatric Endocrinology, Department of Pediatrics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.

Genetics, Reproduction and Development (GRAD), Vrije Universiteit Brussel (VUB), Brussels, Belgium.

出版信息

Front Endocrinol (Lausanne). 2024 Sep 30;15:1459998. doi: 10.3389/fendo.2024.1459998. eCollection 2024.

Abstract

Growth hormone (GH) deficiency (GHD) in children and adolescents can vary in severity and origin, with GH replacement therapy proving effective in achieving genetic target height. Optimal outcomes are seen in those treated early and with higher doses. As patients approach adult height, priorities shift towards optimizing metabolic effects, maintaining body composition, and enhancing bone mass and muscle strength. Transitioning from pediatric to adult care presents challenges, including accurately identifying candidates for continued GH therapy, reevaluating persistent GHD, and preventing treatment discontinuation. Assessing readiness for transition and self-management skills is crucial. This Policy and Practice Review provides a comprehensive overview of current policies, regulations, and guidelines pertinent to managing GHD transition in Belgium. We integrate perspectives from national academic and nonacademic clinical stakeholders in pediatric and adult endocrine care to provide an updated policy framework. This framework underscores the importance of sustained GH therapy during transition, particularly for individuals with persistent GHD, with the goal of optimizing practices and improving outcomes during this critical period.

摘要

儿童和青少年生长激素(GH)缺乏症(GHD)的严重程度和病因各异,GH 替代疗法在实现遗传靶身高方面证明是有效的。早期和高剂量治疗可获得最佳效果。随着患者接近成年身高,重点转向优化代谢效应、维持身体成分以及增强骨量和肌肉力量。从儿科到成人护理的过渡带来了挑战,包括准确识别继续接受 GH 治疗的候选者、重新评估持续 GHD 以及防止治疗中断。评估过渡准备情况和自我管理技能至关重要。本政策和实践综述提供了比利时管理 GHD 过渡的现行政策、法规和指南的全面概述。我们整合了国家学术和非学术临床利益相关者在儿科和成人内分泌科的观点,以提供更新的政策框架。该框架强调了在过渡期间持续进行 GH 治疗的重要性,特别是对于持续存在 GHD 的个体,目的是优化这一关键时期的实践和改善结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/11482521/2968d3f8a23c/fendo-15-1459998-g001.jpg

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