Secondary IGF-I deficiency as a prognostic factor of growth hormone (GH) therapy effectiveness in children with isolated, non-acquired GH deficiency.
Secondary IGF-I deficiency as a prognostic factor of growth hormone (GH) therapy effectiveness in children with isolated, non-acquired GH deficiency.
复制标题
继发性 IGF-I 缺乏症是孤立性非获得性 GH 缺乏症儿童生长激素 (GH) 治疗效果的预后因素。
DOI：
--
复制
发表时间：
2015
影响因子：
1.8
通讯作者：
A. Lewiński
中科院分区：
文献类型：
--
作者：
J. Smyczyńska;R. Stawerska;M. Hilczer;A. Lewiński
目标
生长激素 (GH) 缺乏症 (GHD) 最近被归类为继发性 IGF-I 缺乏症，但 IGF-I 测量在诊断 GHD 中的意义仍在讨论中。该研究的目的是评估 GHD 儿童的 IGF-I 分泌与 GH 治疗效果之间的关系。
患者和方法
该分析包括 300 名患有孤立性非获得性 GHD（GH 峰值低于 10μg/l）的儿童，他们完成了 GH 治疗并达到了最终身高 (FH)。在治疗前测量所有患者的 IGF-I 浓度，如果年龄和性别的 IGF-I SDS 低于 -1.0，则诊断 IGF-I 缺乏。评估以下生长学指标：治疗前患者的身高 SDS (H₀SDS)、FH SDS 以及 FHSDS 相对于 H₀SDS 的改善 (ΔHSDS)。
结果
在IGF-I缺乏的患者中，与治疗前IGF-I分泌正常的患者相比，尽管H₀SDS相似，但观察到FH SDS（-1.42±0.90 vs. -1.74±0.86，p=0.004）和ΔHSDS（1.64±1.01 vs. 1.32±1.05，p=0.010）明显更好。 （- 3.07±0.78 对比 - 3.11±0.77，p=0.63）和 GH 峰（7.0±3.1 μg/l 对比 6.8±2.1 μg/l，p=0.55）。尽管 GH 峰值相似（7.0±2.3μg/l vs. 6.7±3.1μg/l），但 FH 超过 10（th）百分位数的患者治疗前 IGF-I SDS 显着低于 FH 低于 10（th）百分位数的患者（- 1.59±1.54 比 - 1.20±1.64，p=0.04）。 p=0.45）。 ΔHSDS 高于中值的患者的 IGF-I SDS 显着低于 ΔHSDS 低于中值的患者（- 1.59±1.71 比 - 1.09±1.47，p<0.0001），尽管 GH 峰值相似（6.8±2.5 μg/l 与 7.0±2.7 μg/l，p=0.86）。
结论
对于患有孤立性非获得性 GHD 的儿童，继发性 IGF-I 缺乏是 GH 治疗效果更好的重要预测因素。
OBJECTIVE
Growth hormone (GH) deficiency (GHD) has recently been classified as secondary IGF-I deficiency but the significance of IGF-I measurement in diagnosing GHD is still discussed. The aim of the study was to assess the relationships between IGF-I secretion and GH therapy effectiveness in children with GHD.
PATIENTS AND METHODS
The analysis comprised 300 children with isolated, non-acquired GHD (GH peak below 10 μg/l) who completed GH therapy and attained final height (FH). In all patients IGF-I concentration was measured before the treatment and IGF-I deficiency was diagnosed if IGF-I SDS for age and sex was below -1.0. The following auxological indices were assessed: patients' height SDS before treatment (H₀SDS), FH SDS and improvement of FHSDS vs. H₀SDS (ΔHSDS).
RESULTS
In the patients with IGF-I deficiency when compared with those with normal IGF-I secretion before treatment, significantly better FH SDS (-1.42±0.90 vs. -1.74±0.86, p=0.004) and ΔHSDS (1.64±1.01 vs. 1.32±1.05, p=0.010) were observed, despite similar H₀SDS (- 3.07±0.78 vs. - 3.11±0.77, p=0.63) and GH peak (7.0±3.1 μg/l vs. 6.8±2.1 μg/l, p=0.55). The patients who achieved FH over 10(th) centile had significantly lower IGF-I SDS before treatment than those with FH below 10(th) centile (- 1.59±1.54 vs. - 1.20±1.64, p=0.04), despite similar GH peak (7.0±2.3 μg/l vs. 6.7±3.1 μg/l, p=0.45). The patients with ΔHSDS over the median value had significantly lower IGF-I SDS than those with ΔHSDS below the median value (- 1.59±1.71 vs. - 1.09±1.47, p<0.0001), despite similar GH peak (6.8±2.5 μg/l vs. 7.0±2.7 μg/l, p=0.86).
CONCLUSION
In children with isolated, non-acquired GHD, secondary IGF-I deficiency is an important predictor of better GH therapy effectiveness.