Bernasconi S, Street M E, Volta C, Mazzardo G
Dipartimento di Scinze Ginecologiche, Ostetriche e Pediatriche, University of Modena, Italy.
Clin Endocrinol (Oxf). 1997 Sep;47(3):261-6; discussion 267. doi: 10.1046/j.1365-2265.1997.2751082.x.
To evaluate the final height of nongrowth hormone deficient (N-GHD) children treated with growth hormone (GH).
Multicentre retrospective study.
71 (54M/17F) N-GHD children (peak GH after pharmacological stimulation > 14-24 mU/l) who had been treated for 4.19 +/- 0.14 years with GH (0.69 +/- 0.02 IU/kg/week).
Height (H) and height velocity (HV) expressed as standard deviation score (SDS) for chronological age (CA) and bone age (BA), BA/CA ratio, and predicted adult height (PAHSDS) were evaluated before and during treatment, and at each pubertal stage. Target height (TH), and final height (FH) were also calculated, and expressed as SDS.
In the whole group, HSDS for CA increased significantly after the first year on GH, and remained significantly increased for 4 years. This did not occur to HSDS for BA, owing to a significant increase in BA/CA after the first year of therapy. In addition, this increase coincided with stages 4 and 5 of puberty. HVSDS for CA and BA also increased significantly after the first year of treatment, and remained significantly elevated for 4 years. PAHSDS did not change significantly during treatment. FHSDS (-1.69 +/- 0.07) was similar to PAHSDS (-1.6 +/- 0.12) and target height (THSDS) (-1.46 +/- 0.08). FHSDS was > or = THSDS in 36.6% of the patients, and > or = initial PAHSDS in 34.5%. Male patients were subdivided into 2 groups (A and B). Patients in Group A (n = 26) started treatment at puberty, while group B (n = 28) consisted of subjects who started therapy during prepubertal years. Height, height velocity and predicted adult height showed the same pattern as in the whole group, in each subgroup. BA/CA advanced significantly in group A after the second year on GH and in group B, after at least 3 years of therapy. FHSDS, THSDS, and PAHSDS were similar in both groups (-1. 7 +/- 0.13, -1.29 +/- 0.2 and -1.39 +/- 0.15 in group A and -1.48 +/- 0.11, -1.85 +/- 0.15 and -1.36 +/- 0.12 in group B, respectively). However, in group B (prepubertal), FHSDS was > or = initial PAHSDS in 60% of the patients and > or = THSDS in 40.7%, while in group A (pubertal), FHSDS was > or = initial PAHSDS only in 22.7% of the patients and > or = THSDS in 34.6%. FHSDS was found to be correlated with THSDS, PAHSDS at the onset of treatment, and after 1 year of treatment. The age at the beginning of puberty, and the duration of puberty were appropriate in all groups.
GH treatment was effective in increasing height velocity of short non-GH-deficient children, but final height was not definitely improved with respect to initial predicted adult height.
评估生长激素（GH）治疗非生长激素缺乏（N-GHD）儿童的最终身高。
多中心回顾性研究。
71例（54例男性/17例女性）N-GHD儿童（药物刺激后峰值GH>14 - 24 mU/l），接受GH治疗4.19±0.14年（0.69±0.02 IU/kg/周）。
治疗前、治疗期间及各青春期阶段评估身高（H）和身高速度（HV），以按年龄（CA）和骨龄（BA）的标准差评分（SDS）表示，计算BA/CA比值及预测成人身高（PAHSDS）。还计算并以SDS表示靶身高（TH）和最终身高（FH）。
在整个组中，GH治疗第1年后按年龄的身高SDS（HSDS）显著增加，并持续4年显著升高。按骨龄的HSDS未出现这种情况，因为治疗第1年后BA/CA显著增加。此外，这种增加与青春期4期和5期一致。治疗第1年后按年龄和骨龄的身高速度SDS（HVSDS）也显著增加，并持续4年显著升高。治疗期间PAHSDS无显著变化。最终身高SDS（-1.69±0.07）与PAHSDS（-1.6±0.12）和靶身高（THSDS）（-1.46±0.08）相似。36.6%的患者最终身高SDS≥靶身高SDS，34.5%的患者最终身高SDS≥初始PAHSDS。男性患者分为2组（A组和B组）。A组（n = 26）在青春期开始治疗，而B组（n = 28）由青春期前开始治疗的受试者组成。每个亚组中身高、身高速度和预测成人身高与整个组表现出相同模式。GH治疗第2年后A组和治疗至少3年后B组的BA/CA显著提前。两组的最终身高SDS、靶身高SDS和PAHSDS相似（A组分别为-1.7±0.13、-1.29±0.2和-1.39±0.15；B组分别为-1.48±0.11、-1.85±0.15和-1.36±0.12）。然而，B组（青春期前）60%的患者最终身高SDS≥初始PAHSDS，40.7%的患者最终身高SDS≥靶身高SDS；而A组（青春期）仅22.7%的患者最终身高SDS≥初始PAHSDS，34.6%的患者最终身高SDS≥靶身高SDS。发现最终身高SDS与治疗开始时及治疗1年后的靶身高SDS、PAHSDS相关。所有组的青春期开始年龄和青春期持续时间均正常。
GH治疗对增加非GH缺乏的矮小儿童的身高速度有效，但相对于初始预测成人身高，最终身高并未得到明确改善。
