适应生长激素敏感性的生长激素治疗在异常性矮身患者中
Anne R Kruijsen1, Jan M Wit1, Kirsten de Groote1
1Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, PO Box 9600, Leiden 2300RC, The Netherlands.
European journal of endocrinology
|July 7, 2025
概括
具有特异性矮身 (ISS) 和低胰岛素样生长因子I (IGF-1) 水平的儿童对复合人体生长激素 (rhGH) 治疗反应良好. IGF-1生成测试 (IGFGT) 有助于优化这些患者的rhGH剂量.
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
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 异形矮身 (ISS) 影响了身高矮的儿童,没有可识别的原因.
- 评估生长激素 (GH) 敏感性对于有效治疗至关重要.
- 降低胰岛素样生长因子I (IGF-1) 水平可能表明GH耐药性.
研究的目的:
- 评估ISS,低IGF-1和正常GH峰值的儿童对复合人体生长激素 (rhGH) 的长期生长反应.
- 评估IGF-1生成试验 (IGFGT) 在分层GH敏感性方面的实用性.
- 根据GH敏感度来确定最佳的rhGH剂量策略.
主要方法:
- 对129名患有ISS的儿童进行了回顾性描述案例系列.
- IGFGT用于将患者分类为正常,中等或低GH敏感性组.
- 根据IGFGT结果,用不同剂量的rhGH治疗;患者至少接受1年的随访.
主要成果:
- 患者通过rhGH疗法实现了显著的身高增长,并改善了预测的成人身高 (PAH).
- 接近成年人身高 (NAH) 的平均值为-1.0 SDS,与基线相比大幅改善.
- 治疗结果与ISS和GH缺乏的既定模型预测的结果相似或更好.
结论:
- 患有ISS,低IGF-1和正常GH峰值的儿童对rhGH表现出积极的反应.
- 在IGFGT是有价值的识别适合的候选人对rhGH治疗和量身定制剂量.
- 优化的rhGH治疗可以显著改善这一特定儿科群体的生长结果.
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