The definition of a spontaneous growth hormone (GH) peak: studies in normally growing and GH-deficient children.
The definition of a spontaneous growth hormone (GH) peak: studies in normally growing and GH-deficient children.
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自发生长激素 (GH) 峰值的定义：对正常生长和 GH 缺乏儿童的研究。
DOI：
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发表时间：
1992
影响因子：
5.8
通讯作者：
A. Kowarski
中科院分区：
文献类型：
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作者：
Zvi Zadik;S. Chalew;A. Kowarski
生长激素自发峰值及其诊断价值以前没有通过24小时持续停药(CW)程序对生长障碍儿童进行评估。我们用CW泵研究了129名青春期前受试者24小时内GH的自发分泌。对照组(C组)：20名身高、生长速度正常的儿童。GHD组53例，其中特发性48例，器质性5例。NSD组36例，生长速度低于4.5 cm/年，对刺激刺激(PS)的GH反应正常，但平均24小时GH处于缺陷范围。NSS组20例，身高矮小，生长速度正常，PS正常，平均24 h GH浓度正常。C组、GHD组、NSD组和NSS组24小时内的平均生长激素水平分别为4.1+/-1.7、1.4+/-0.5、2.1+/-0.7和4.2+/-1.9。对于每个受试者，在CW研究期间收集的48个0.5h样本中测定了GH水平，并通过Pulsar计算机程序分析了GH谱。C的平均峰数为9.0+/-2.5，GHD为9.5+/-3.7，NSD为10.5+/-1.8，NSS为9.5+/-3.2。两组间差异无统计学意义。C、GHD、NSD和NSS的平均波幅分别为9.8+/-8.9、1.6+/-1.0、2.9+/-1.3和9.9+/-9.1。GHD组和NSD组的平均波幅均显著低于C组和NSS组。白天(800~2000h)峰值>8微克/L是生长激素积分浓度(IC-GH)正常儿童的特征，90%生长正常儿童出现峰值，而IC-GH发育不良儿童仅有7%出现峰值。C组与NSD组夜间脉搏数无显著差异。我们的结论是，生长正常儿童和生长不良儿童之间的IC-GH差异是由于白天峰值较低所致。
GH spontaneous peaks and their diagnostic utility have not been previously evaluated by means of a 24-h continuous withdrawal (CW) procedure in children with growth disorders. Using a CW pump, we studied the 24-h spontaneous secretion of GH in 129 prepubertal subjects grouped as follows. The control group (C) consisted of 20 children of normal height and growth rate. Group GHD consisted of 53 patients with classical GH deficiency (48 idiopathic and 5 organic). The NSD group consisted of 36 patients with a growth velocity below 4.5 cm/yr, normal GH response to provocative stimuli (PS), but a mean 24-h GH in the deficient range. Group NSS consisted of 20 short children with normal growth velocity, normal PS, and normal mean 24-h GH concentration. The mean GH levels for the 24-h period were 4.1 +/- 1.7, 1.4 +/- 0.5, 2.1 +/- 0.7, and 4.2 +/- 1.9, respectively, for the C, GHD, NSD, and NSS groups. For each subject, GH levels were determined in 48 0.5-h samples collected during the CW study, and the GH profile was analyzed by the Pulsar computer program. The mean number of peaks was 9.0 +/- 2.5 for C, 9.5 +/- 3.7 for GHD, 10.5 +/- 1.8 for NSD, and 9.5 +/- 3.2 for NSS. There was no statistical difference between groups. The mean amplitude of peaks was 9.8 +/- 8.9 for C, 1.6 +/- 1.0 for GHD, 2.9 +/- 1.3 for NSD, and 9.9 +/- 9.1 for NSS. Mean peak amplitudes in both GHD and NSD were significantly lower than in the C and NSS groups. The presence of peaks of more than 8 micrograms/L during the daytime (0800-2000 h) was a characteristic of children with normal integrated GH concentration (IC-GH) and was seen in 90% of normally growing children but in only 7% of poorly growing children with subnormal IC-GH. There was no significant difference in the number of pulses during the night between C and NSD groups. We conclude that differences in IC-GH between normally growing and poorly growing children are due to a lower amplitude of peaks during the daytime hours.