没有GH的增长:一个案例系列和文献综述
Stefana Catalina Bilha1,2, Cristina Preda1,2, Letitia Leustean1,2
1Endocrinology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Journal of clinical medicine
|December 30, 2025
概括
严重的生长激素 (GH) 缺乏并不总是阻止正常或高个体,这表明其他因素推动了线性生长. 在这些情况下,重点应该转移到代谢健康.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 增长和发展 增长和发展
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 线性生长主要与生长激素 (GH) /胰岛素类生长因子-1 (IGF-1) 轴相关.
- 然而",没有GH的增长"的案例挑战了这个范式,表明了其他有助于增长的因素.
- 患有GH缺乏症的患者经常出现肥胖和代谢并发症.
研究的目的:
- 研究严重GH缺乏和IGF-1持续低水平的患者的线性生长机制.
- 探索GH/IGF-1轴以外的其他因素在实现正常或高身高方面所起的作用.
- 评估复合人体GH (rhGH) 对这一群体生长和代谢结果的影响.
主要方法:
- 五名患有严重GH缺乏症 (一例先天性,四例获得) 和低IGF-1的患者的病例系列.
- 分析生长模式,代谢参数 (肥胖,胰岛素耐药性,失脂症,脂肪肝),以及对治疗的反应 (性类固醇,rhGH).
- 对已发表的"没有GH的生长"病例进行文献审查,以将研究结果置于背景.
主要成果:
- 所有五名患者的身材都正常或高,尽管严重的GH缺乏和IGF-1的低水平.
- 在大多数情况下,生长独立于性别类固醇替代; 一名患者表现出长时间的生长与延迟的体融合,由于阴性腺症.
- 三名患者的rhGH治疗没有显著影响生长速度,但显示出良好的代谢结果,改善脂质配置和脂肪肝炎.
结论:
- 严重的GH缺乏不排除正常或加速的线性生长,突出多因素的增长驱动因素.
- 诸如胰岛素信号传递,甲状腺激素作用,局部生长板路径和遗传修饰剂等因素可能有助于.
- "没有GH的增长"的治疗重点应该优先考虑心脏代谢风险降低,在密切监测下考虑rHGH的代谢益处.
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