纵向血红蛋白轨迹及其与矮小儿童(年龄<15岁)每周接受生长激素治疗的生长反应的关系:一项真实世界队列研究。

IF 2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
International Journal of General Medicine Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S541514
Qingbo Xu, Yu Yang, Liling Xie, Dongguang Zhang, Haiying Zou, LanFang Cao, Li Yang
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引用次数: 0

摘要

背景:生长激素(GH)治疗影响线性生长并可能影响造血,但儿童血红蛋白(Hb)的动态变化尚不清楚。目的:研究矮小患者(包括特发性矮小(ISS)和生长激素缺乏症(GHD))每周GH治疗期间Hb的纵向轨迹,并评估其与生长反应的关系。方法:这项回顾性队列研究包括165名身材矮小的儿童,每周接受一次聚乙二醇化生长激素治疗至少12个月。在基线、6个月和12个月收集血液学/生长相关参数。基于组的轨迹建模(GBTM)确定Hb轨迹组。采用Spearman相关分析评估Hb、红细胞(RBC)计数和胰岛素样生长因子1 (IGF-1)之间的关系。多因素logistic回归用于确定Hb改善的预测因子(≥5 g/L)。结果:确定了3种不同的Hb轨迹组:上升(n = 82),上升后下降(n = 51)和稳定(n = 32)。上升组在12个月时表现出最有利的身高SDS改善(平均ΔHtSDS = 1.01),而先上升后下降和稳定组则表现出更温和的增长。IGF-1水平与12个月时Hb (ρ = 0.308, p = 0.001)和RBC计数(ρ = 0.236, p = 0.014)中度相关。Logistic回归显示Hb改善没有独立的基线预测因子;然而,纳入Hb轨迹组显著增强了生长反应的预测模型(调整后的R²从0.129增加到0.240;p = 0.018)。结论:Hb轨迹在接受生长激素治疗的儿童中有显著差异,并且与身高结果有一定的相关性。Hb的纵向监测可以作为一种具有成本效益的动态生物标志物,指导儿童生长障碍的个性化生长激素剂量滴定。如果得到验证,Hb监测可以作为儿科生长障碍个性化生长激素剂量的实用生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Longitudinal Hemoglobin Trajectories and Their Association with Growth Response in Short Stature Children (Aged <15 Years) Undergoing Weekly Growth Hormone Therapy: A Real-World Cohort Study.

Longitudinal Hemoglobin Trajectories and Their Association with Growth Response in Short Stature Children (Aged <15 Years) Undergoing Weekly Growth Hormone Therapy: A Real-World Cohort Study.

Longitudinal Hemoglobin Trajectories and Their Association with Growth Response in Short Stature Children (Aged <15 Years) Undergoing Weekly Growth Hormone Therapy: A Real-World Cohort Study.

Longitudinal Hemoglobin Trajectories and Their Association with Growth Response in Short Stature Children (Aged <15 Years) Undergoing Weekly Growth Hormone Therapy: A Real-World Cohort Study.

Background: Growth hormone (GH) therapy affects linear growth and may influence hematopoiesis, but dynamic hemoglobin (Hb) changes in children remain unclear.

Objective: To characterize longitudinal Hb trajectories during weekly GH treatment in short stature, including idiopathic short stature (ISS) and growth hormone deficiency (GHD), and to assess their associations with growth response.

Methods: This retrospective cohort study included 165 children with short stature who received once-weekly PEGylated GH therapy for at least 12 months. Hematologic/growth-related parameters were collected at baseline, 6 and 12 months. Group-based trajectory modeling (GBTM) identified Hb trajectory groups. Spearman correlation analysis was performed to evaluate the association between Hb, red blood cell (RBC) count, and insulin-like growth factor 1 (IGF-1). Multivariate logistic regression was used to identify predictors of Hb improvement (≥5 g/L).

Results: Three distinct Hb trajectory groups were identified: ascending (n = 82), ascending-then-descending (n = 51), and stable (n = 32). The ascending group demonstrated the most favorable height SDS improvement at 12 months (mean ΔHtSDS = 1.01), while the ascending-then-descending and stable groups showed more modest gains. IGF-1 levels were moderately correlated with Hb at 12 months (ρ = 0.308, p = 0.001) and RBC counts (ρ = 0.236, p = 0.014). Logistic regression revealed no independent baseline predictor of Hb improvement; however, the inclusion of Hb trajectory group significantly enhanced the predictive model for growth response (adjusted increased from 0.129 to 0.240; p = 0.018).

Conclusion: Hb trajectories vary significantly among children receiving GH therapy and are moderately associated with height outcomes. Longitudinal monitoring of Hb may serve as a cost-effective dynamic biomarker to guide personalized GH dose titration in pediatric growth disorders. If validated, Hb monitoring may serve as a practical biomarker for personalized GH dosing in pediatric growth disorders.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
自引率
0.00%
发文量
1113
审稿时长
16 weeks
期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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