Saenger P, Attie K M, DiMartino-Nardi J, Hintz R, Frahm L, Frane J W
Department of Pediatrics, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
J Clin Endocrinol Metab. 1998 Sep;83(9):3115-20. doi: 10.1210/jcem.83.9.5089.
In a multicenter study the metabolic effects of 5 yr of GH therapy in children with idiopathic short stature were evaluated. Patients received 0.3 mg/kg.week recombinant human GH. Of the 121 patients who entered the study, data for 62 were analyzed at the final 5 yr point. Routine laboratory determinations were available for all 62 subjects at the 5 yr point. Special laboratory determinations, such as postprandial glucose and insulin, were available for only a subset of patients. Mean insulin-like growth factor I levels rose to 283 +/- 101 micrograms/L, within the normal range using age-appropriate reference standards. T4, cholesterol, triglycerides, blood chemistries, and blood pressure showed no significant changes during the 5-yr period. Mean baseline and 2-h postprandial glucose levels remained unchanged. Both fasting and postprandial insulin levels rose substantively from low normal levels to the normal range (median, 4.9-43 mU/L). Mean hemoglobin A1c levels remained within the normal range throughout the study. In summary, careful monitoring has not revealed any currently discernible metabolic side-effects of clinical significance after GH therapy in this 5-yr study of children with idiopathic short stature.
在一项多中心研究中,评估了生长激素(GH)治疗5年对特发性矮小儿童的代谢影响。患者接受0.3mg/kg·周的重组人生长激素治疗。在进入研究的121例患者中,对5年后的62例患者的数据进行了分析。在5年时,所有62例受试者均进行了常规实验室检测。只有部分患者进行了特殊实验室检测,如餐后血糖和胰岛素检测。使用年龄匹配的参考标准,胰岛素样生长因子I平均水平升至283±101μg/L,处于正常范围内。甲状腺素、胆固醇、甘油三酯、血液化学指标和血压在5年期间无显著变化。平均基线和餐后2小时血糖水平保持不变。空腹和餐后胰岛素水平均从略低于正常水平大幅升至正常范围(中位数,4.9 - 43mU/L)。在整个研究中,糖化血红蛋白A1c平均水平保持在正常范围内。总之,在这项针对特发性矮小儿童的5年研究中,经过仔细监测,未发现生长激素治疗后有任何目前可察觉的具有临床意义的代谢副作用。