通过低剂量重组人生长激素疗法达到最佳最终成人身高

IF 0.4 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Asian Biomedicine Pub Date : 2024-05-02 DOI:10.2478/abm-2024-0011

Tansit Saengkaew, Suparb Aroonparkmongkol, Suttipong Wacharasindhu

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引用次数: 0

摘要

背景泰国采用重组人生长激素（rhGH）治疗已有 20 年历史。由于资源有限，人们一直致力于以最低可行剂量使用 rhGH。然而，目前在疗效和结果方面缺乏证据。目的评估生长激素（GH）治疗的辅助治疗效果以及达到最终成人身高（FAH）并停用rhGH后的GH分泌能力。方法回顾性分析 40 例患者的数据。评估了rhGH治疗前和治疗期间的临床特征、辅助检查数据以及生化和内分泌检查结果。此外，还使用胰岛素耐量试验对24名患者进行了GH复测。结果 20名患者（50%）患有完全性生长激素缺乏症（GHD），即刺激性GH峰值水平为5纳克/毫升，其余患者为部分性GHD。大多数患者为男性（n = 25，62.5%）。开始使用rhGH的平均年龄为8.9岁。与完全性GHD患者相比，部分GHD患者接受的rhGH剂量更高（30.9 µg/kg/d vs. 26.2 µg/kg/d，P = 0.02）。完全性和部分性GHD患者在身高标准偏差评分（SDS）分别为-0.65和-1.47时达到FAH。在身高增长方面获得良好临床反应的相关因素包括GH刺激峰值水平、青春期年龄和停用rhGH的年龄。完成rhGH治疗后，24名患者中有13人的GH分泌正常。多发性垂体激素缺乏症（MPHD）患者很可能在成年后持续存在GHD（8例，88.9%）。结论本研究表明，使用低剂量 rhGH 可使健康人群达到最佳 FAHs。多发性多器官功能障碍患者可能不需要重新检测，因为他们很可能患有持续性多发性多器官功能障碍。这项研究获得的结果凸显了治疗的益处。这种治疗方法可用于资源有限的国家。

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Optimal final adult height achieved by low-dose recombinant human growth hormone therapy

Background Thailand has been administering the recombinant human growth hormone (rhGH) treatment for >20 years. Due to limited resources being available, efforts have been directed toward utilizing rhGH at the lowest feasible dose. However, there is currently a lack of evidence in terms of the efficacy and outcomes. Objective To evaluate the auxological outcomes of growth hormone (GH) treatment and the GH secretion ability after reaching final adult height (FAH) and discontinuing rhGH. Methods Data of 40 patients were retrospectively reviewed. The clinical characteristics, auxological data, and results of biochemical and endocrine investigations before and during rhGH treatment were evaluated. In addition, GH retesting was performed in 24 patients using the insulin tolerance test. Results Twenty patients (50%) had complete growth hormone deficiency (GHD), defined as peak stimulated GH level <5 ng/mL, and the remaining patients had partial GHD. Most patients were male (n = 25, 62.5%). The mean age at which rhGH was initiated was 8.9 years. Patients with partial GHD received a higher dose of rhGH than those with complete GHD (30.9 µg/kg/d vs. 26.2 µg/kg/d, P = 0.02). Patients with complete and partial GHD reached FAH at height standard deviation scores (SDSs) of −0.65 and −1.47, respectively. The factors associated with obtaining a good clinical response in terms of height gain included peak-stimulated GH level, age of puberty, and age of discontinuing rhGH. After completing the rhGH treatment, 13 of the 24 patients showed normal GH secretion. Patients with multiple pituitary hormone deficiency (MPHD) were likely to have persistent GHD through adulthood (n = 8, 88.9%). Conclusion This study has demonstrated that the use of low-dose rhGH could result in healthy populations achieving optimal FAHs. Patients with MPHD might not require retesting as they were likely to have persistent GHD. The results obtained in this research highlight the benefits of the treatment. This treatment can be applied in resource-limited countries.

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来源期刊

Asian Biomedicine 医学-医学：研究与实验

CiteScore

1.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.