在接受重组生长激素治疗的儿童中解释IGF-1:在早期青春期的挑战
Helena-Jamin Ly1,2, Carina Ankarberg-Lindgren1, Hans Fors1,2
1Department of Pediatrics, Göteborg Pediatric Growth Research Center (GP-GRC), Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Frontiers in endocrinology
|February 5, 2025
概括
在儿童生长激素 (GH) 治疗期间解释胰岛素样生长因子-1 (IGF-1) 水平是复杂的,因为性类固醇水平波动. 调整IGF-1解释与性类固醇数据可以增强儿童GH治疗监测.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 增长激素治疗疗法 增长激素治疗
- 生物化学监测 生物化学监测
背景情况:
- 重组生长激素 (GH) 给患有GH缺乏症的儿童的剂量产生了可变的反应.
- 胰岛素样生长因子-1 (IGF-1) 有助于监测GH治疗,但其解释因年龄,性别和青春期状态而复杂.
研究的目的:
- 描述性地评估青春期症状和性类固醇水平对接受GH治疗的儿童IGF-1解释的影响.
- 评估在青春期过渡期间使用IGF-1监测生长激素治疗的挑战.
主要方法:
- 包括93名青春期前儿童 (67名男孩,26名女孩) 来自之前的GH治疗试验.
- 收集了关于年龄,青春期阶段,GH剂量和每名儿童至少5年的IGF-1水平的数据.
- 从储存的样本中分析了雌激醇和的水平,以与青春期状态和IGF-1相关联.
主要成果:
- 在根据坦纳阶段分类为青春期前儿童的显著比例中,观察到青春期雌激醇和的升高水平.
- 具有更高IGF-1标准偏差分数 (SDS) 的儿童接受了更高的GH剂量 (p<0.001).
- 在女孩和男孩中,较低的性别类固醇水平与更高的IGF-1 SDS有关,这表明在不考虑这些因素的情况下可能存在误解.
结论:
- 性类固醇在青春期过渡期间显著影响IGF-1的解释,可能导致IGF-1SDS的高估.
- 建立包含性类固醇水平的IGF-1参考范围可以提高IGF-1用于监测GH治疗的临床效用.
- 精确监测GH治疗需要考虑个体的青春期状态和性别类固醇变异.
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