Growth Hormone Treatment Improves Cognitive Function in Short Children with Growth Hormone Deficiency
Growth Hormone Treatment Improves Cognitive Function in Short Children with Growth Hormone Deficiency
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DOI：
10.1159/000375529
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发表时间：
2015-01-01
影响因子：
3.2
通讯作者：
Albertsson-Wikland, Kerstin
中科院分区：
文献类型：
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作者：
Chaplin, John Eric;Kristrom, Berit;Albertsson-Wikland, Kerstin
背景/目标：我们调查了认知和生长激素（GH）的状态和GH治疗的短青春期前儿童广泛的GH分泌之间的关联。研究方法：共有99名儿童（年龄3-11岁），41名GH缺乏症（GHD）和58名特发性身材矮小症（ISS），被随机分配至固定剂量（43 μ g/kg/天）或预测模型指导的个体化剂量（17-100 μ g/kg/天），并随访24个月。在一项纵向和混合的受试者内和受试者之间的研究中，我们研究了临床效应量的变化，通过科恩d测量，在全面智商（FSIQ）和二级智商指数。结果如下：在GH缺乏组中，FSIQ（p = 0.001，Cohen’s d = 0.63）、操作智商（p = 0.001，Cohen’s d = 0.65）和处理速度（p = 0.005，Cohen’s d = 0.71）的中等效应量显著增加。相比之下，感知组织仅在ISS组中增加（p = 0.001，Cohen's d = 0.53）。基线IQ呈正态分布，两组间差异较小但显著：GH缺乏儿童FSIQ较低（p = 0.042），操作IQ较低（p = 0.021）。使用多元回归分析，基线时GH（max）和IGF-I-SDS解释了Delta处理速度评分（0-24个月）中40%的方差。结论：生长激素缺乏儿童的智商，特别是液体智力增加。GH/IGF-I轴的治疗前状态对这些变化具有显著的预测作用。(C)2015 S. Karger AG，巴塞尔
Background/Aims: We investigated the association between cognition and growth hormone (GH) status and GH treatment in short prepubertal children with broadly ranging GH secretion. Methods: A total of 99 children (age 3-11 years), 41 with GH deficiency (GHD) and 58 with idiopathic short stature (ISS), were randomized to a fixed dose (43 mu g/kg/day) or a prediction model-guided individualized dose (17-100 mu g/kg/day) and followed up for 24 months. In a longitudinal and mixed within-and between-subjects study, we examined clinical effect size changes, measured by Cohen's d, in full-scale IQ (FSIQ) and secondary IQ indices. Results: Significant increases giving medium effect size in FSIQ (p = 0.001, Cohen's d = 0.63), performance IQ (p = 0.001, Cohen's d = 0.65) and processing speed (p = 0.005, Cohen's d = 0.71) were found in the GH-deficient group. In contrast, perceptual organization only increased in the ISS group (p = 0.001, Cohen's d = 0.53). Baseline IQ was normally distributed with small but significant differences between the groups: GH-deficient children had lower FSIQ (p = 0.042) and lower performance IQ (p = 0.021). Using multiple regression analysis, 40% of the variance in delta processing speed scores (0-24 months) was explained by GH(max) and IGF-I-SDS at baseline. Conclusion: IQ, specifically fluid intelligence, increased in the GH-deficient children. The pretreatment status of the GH/IGF-I axis was significantly predictive for these changes. (C) 2015 S. Karger AG, Basel