Stimulation of statural growth by recombinant insulin-like growth factor I in a child with growth hormone insensitivity syndrome (Laron type)
Stimulation of statural growth by recombinant insulin-like growth factor I in a child with growth hormone insensitivity syndrome (Laron type)
复制标题
重组胰岛素样生长因子 I 对生长激素不敏感综合征（拉伦型）儿童的体形生长的刺激
DOI：
10.1016/s0022-3476(05)81163-1
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Underwood,LE
中科院分区：
文献类型：
--
作者：
Walker,JL;VanWyk,JJ;Underwood,LE
我们研究了一名患有生长激素不敏感综合征的9.7岁儿童，每天两次皮下注射胰岛素样生长因子I(IGF-I)，每次120μg/kg，治疗9个月的效果，短期研究表明IGF-I可能促进线性生长。身高速度从6.5 cm/yr(+1.7 SD评分)增加到11.4 cm/yr(+8.8 SD评分)。血清胰岛素样生长因子-I浓度由治疗前的9±2μg/L上升到治疗后2小时的峰值347±26μg/L。血清IGF-II浓度无明显变化。基础但未受刺激的生长激素浓度均下降。治疗前12天，血药浓度和24小时尿尿素氮排泄量分别下降28%和10%(p<；0.001)，尿钙排泄量增加2.4倍(p<；0.02)，内生肌酐清除率和尿量分别增加22%和55%(p<；0.02)。10周时，血清尿素氮水平、尿钙和内生肌酐清除率的变化仍然明显。空腹和餐后血糖浓度保持正常。我们得出的结论是，每天两次皮下注射IGF-I在刺激体位生长方面是有效的，而不会产生持续输注IGF-I时观察到的低血糖和高血糖。
We studied the effects of 9 months of treatment with twice-daily subcutaneous injections of insulin-like growth factor I (IGF-I), 120 μg/kg per dose, in a 9.7-year-old child with growth hormone insensitivity syndrome, in whom short-term studies had suggested that IGF-I might promote linear growth. Height velocity increased from 6.5 cm/yr (+1.7 SD score) to 11.4 cm/yr (+8.8 SD score). Serum concentrations of IGF-I increased from pretreatment values of 9±2 μg/L to a peak of 347±26 μg/L after 2 hours. Serum concentrations of IGF-II were unchanged. Basal but not stimulated growth hormone concentrations were decreased. During the first 12 days of treatment, serum concentrations and the 24-hour urinary excretion of urea nitrogen were decreased by 28% and 10%, respectively (p<0.05), there was a 2.4-fold increase in urinary excretion of calcium (p<0.001), and creatinine clearance and urine volume increased by 22% and 55%, respectively (p<0.02). The changes in serum levels of urea nitrogen and in urinary calcium and creatinine clearance were still evident at 10 weeks. Fasting and postprandial serum glucose concentrations remained normal. We conclude that IGF-I given as twice-daily subcutaneous injections is effective in stimulating statural growth without producing the hypoglycemia and hyperglycemia observed when IGF-I is infused continuously.