O'Leary P C, McIntyre E, Feddema P, LeSouëf P N
University Department of Obstetrics and Gynaecology, Princess Margaret and King Edward Memorial Hospitals, Subiaco, Western Australia.
Pediatr Pulmonol. 1996 Jun;21(6):361-6. doi: 10.1002/(SICI)1099-0496(199606)21:6<361::AID-PPUL3>3.0.CO;2-O.
We measured growth hormone (GH) concentrations in first morning urine samples in 110 prepubertal children to determine whether asthma therapies affected GH secretion. The children with asthma were assigned to two groups depending on their asthma treatments: 1) 16 children with a history of asthma, currently not on any treatment, and 2) asthmatics taking inhaled corticosteroids (n = 37), short-term oral corticosteroids (n = 15), or long-term non-corticosteroidal therapies (n = 19). Results obtained from these children were compared with a control group of healthy prepubertal children (n = 23) without previous or current symptoms of asthma. Five consecutive urine samples were collected from each child, and GH concentrations (corrected for urine creatinine) were determined by an enzyme immunoassay. The mean (+/- SD) urine GH concentration determined in the control group (23 healthy prepubertal children) was 15.6 +/- 8.7 ng/L (1.88 +/- 1.29 ng GH/mmol creatinine). The mean (+/- SD) urine GH concentrations in overnight samples were similar in untreated asthmatics (14.1 +/- 6.1 ng/L) and in the treatment groups (14.1 +/- 7.7 ng/L, inhaled corticosteroids; 16.5 +/- 11.7 ng/L, oral corticosteroids; 15.9 +/- 9.8 ng/L, long-term non-corticosteroidal therapies). Irrespective of the manner of expression of urine GH (ng/L) or after correction for urine creatinine concentration (ng GH/mmol), no significant differences were found in the GH excretion among any of the groups. In this study, the intra-individual coefficient of variation for urine GH, expressed as ng/L, ranged between 11 and 87% (median, 32%). When the urine GH was expressed as ng GH/mmol creatinine, the coefficient of variation ranged between 12 and 92% (median, 35%), accounting for approximately 60% of the inter-individual coefficient of variation (mean CV, 56%) and 47% when the urine GH is expressed as ng GH/mmol creatinine. We were unable to determine any short-term differences in urine GH excretion between non-asthmatic children and asthmatics treated with inhaled corticosteroids, oral corticosteroids, or bronchodilators. Our results suggest that there is not an adverse effect of current corticosteroid therapies for childhood asthma on GH secretion.
我们测量了110名青春期前儿童晨尿样本中的生长激素（GH）浓度，以确定哮喘治疗是否会影响GH分泌。患有哮喘的儿童根据其哮喘治疗方法被分为两组：1）16名有哮喘病史、目前未接受任何治疗的儿童，以及2）正在使用吸入性糖皮质激素（n = 37）、短期口服糖皮质激素（n = 15）或长期非糖皮质激素疗法（n = 19）的哮喘患者。将这些儿童的结果与一组无哮喘既往或当前症状的健康青春期前儿童对照组（n = 23）进行比较。从每个儿童收集连续5份尿液样本，并通过酶免疫测定法测定GH浓度（校正尿肌酐）。对照组（23名健康青春期前儿童）测定的平均（±标准差）尿GH浓度为15.6±8.7 ng/L（1.88±1.29 ng GH/mmol肌酐）。未治疗的哮喘患者过夜样本中的平均（±标准差）尿GH浓度（14.1±6.1 ng/L）与治疗组相似（吸入性糖皮质激素组为14.1±7.7 ng/L；口服糖皮质激素组为16.5±11.7 ng/L；长期非糖皮质激素疗法组为15.9±9.8 ng/L）。无论尿GH的表达方式（ng/L）如何，或校正尿肌酐浓度后（ng GH/mmol），各组之间的GH排泄均未发现显著差异。在本研究中，以ng/L表示的尿GH个体内变异系数在11%至87%之间（中位数为32%）。当尿GH以ng GH/mmol肌酐表示时，变异系数在12%至92%之间（中位数为35%），约占个体间变异系数（平均CV为56%）的60%，当尿GH以ng GH/mmol肌酐表示时占47%。我们无法确定非哮喘儿童与接受吸入性糖皮质激素、口服糖皮质激素或支气管扩张剂治疗的哮喘患者之间尿GH排泄的任何短期差异。我们的结果表明，目前用于儿童哮喘的糖皮质激素疗法对GH分泌没有不良影响。
