A LONGITUDINAL-STUDY OF THE RELATIONSHIP OF PLASMA SOMATOMEDIN-C CONCENTRATION TO THE PUBERTAL GROWTH SPURT
A LONGITUDINAL-STUDY OF THE RELATIONSHIP OF PLASMA SOMATOMEDIN-C CONCENTRATION TO THE PUBERTAL GROWTH SPURT
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DOI：
10.1001/archpedi.1987.04460050104041
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发表时间：
1987-05-01
影响因子：
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通讯作者：
FURLANETTO, RW
中科院分区：
文献类型：
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作者：
CARA, JF;ROSENFIELD, RL;FURLANETTO, RW
来自我们机构（芝加哥惠勒儿童医院和费城儿童医院）和其他机构的横断面研究表明，血浆生长调节素-C（Sm-C）浓度在青春期升高。为了确定血浆Sm-C水平升高与青春期生长突增之间的关系，我们对11至18岁的儿童进行了纵向研究。12名男性和8名女性受试者每年随访2至7年（平均4.4年）。在每次访视期间测定身高增长速度、血浆Sm-C浓度和性发育阶段。研究期间，所有患者的青春期进展正常。每个儿童的血浆Sm-C水平在青春期早期升高，并在青春期中期达到最高水平，至少为2 U/mL，大约在达到身高峰值速度后一年。Sm-C的最大血浆浓度在男性中相似（3.5 . ±. 0.71，平均值±。SEM）和女性（3.5 . ±. 1.46）科目。血浆Sm-C水平随后缓慢下降，但仍高于正常成人值长达四年后达到高峰身高速度。血浆Sm-C浓度随着高度流速的增加而稳步增加，直到达到峰值高度流速，高度流速每增加一厘米，平均增加约0.5 U。由于Sm-C水平保持升高，而身高增长速度下降，在整个青春期Sm-C水平和身高增长速度之间没有显着的相关性。这些结果表明，在解释Sm-C浓度在青春期需要谨慎;虽然正常的青春期水平可能在肢端肥大症的成人范围内，血浆Sm-C水平低于1 U/mL在青春期早期或低于1.5 U/mL在青春期中后期必须被视为低于正常。
Cross-sectional studies from our institutions (Wyler Children''s Hospital, Chicago, and Children''s Hospital of Philadelphia) and others have shown that plasma somatomedin-C (Sm-C) concentrations rise during puberty. To determine the relationship between rising plasma Sm-C levels and the growth spurt at puberty, we undertook a longitudinal study of 11- to 18-year-old children. Twelve male and eight female subjects were followed up on a yearly basis for two to seven years (mean, 4.4 years). Height velocity, plasma Sm-C concentrations, and stage of sexual development were determined during each visit. All patients progressed normally in puberty during the study. The plasma Sm-C level rose during early puberty in each child and reached a maximal level of at least 2 U/mL in midpuberty, approximately one year after the attainment of peak height velocity. Maximal plasma concentrations of Sm-C were similar in male (3.5 .+-. 0.71, mean .+-. SEM) and female (3.5 .+-. 1.46) subjects. Plasma Sm-C levels subsequently decreased slowly but remained above normal adult values for as long as four years after peak height velocity was reached. Plasma Sm-C concentrations increased steadily with increasing height velocity until peak height velocity was attained with a mean rise of approximately 0.5 U for each centimeter per year increase in height velocity. Since Sm-C levels remained elevated while height velocity decreased, there was no significant correlation between Sm-C levels and height velocity throughout puberty. These results suggest that caution is required in interpreting Sm-C concentrations during puberty; while normal pubertal levels may be in the acromegalic range for adults, a plasma Sm-C level of less than 1 U/mL in early puberty or less than 1.5 U/mL during middle to late puberty must be considered subnormal.