The therapeutic effect and safety of recombinant human growth hormone in short children born small for gestational age / 中华实用儿科临床杂志

ABSTRACT

Objective To study the therapeutic effect and safety of recombinant human growth hormone in short children born small for gestational age (SGA).Methods Twenty-two short children born SGA were randomly divided into 2 groups and were exposed to different doses of recombinant human growth hormone,which were low dose group [0.1 IU/(kg · d)] and high dose group [0.2 IU/(kg · d)].Treatment was carried out for 2 years.Before and after treatment,height,weight,bone age,insulin-like growth factor 1 (IGF-1),insulin-like growth factor-binding protein 3 (IGFBP-3),growth rate (GV),height standard deviation scores (HtSDS),predicted adult lifetime height (PAH),fasting and postprandial blood glucose,insulin,thyroid stimulating hormone (TSH),T3,T4,and glycosylated hemoglobin were measured.Results Basic value of growth hormone in SGA infant was (2.94 ± 3.27) μg/L.Two years after treatment of growth hormone in high dose group,growth rate [(8.11 ± 1.31) cm/year vs (4.21 ± 0.99) cm/ year],HtSDS(-1.16 ±0.83 vs-3.00 ±0.71),and PAH[(163.68 ±6.76) cm vs (156.54 ±7.39) cm] were significantly higher than those before treatment (F =110.3,30.47,26.20,all P ＜ 0.01).Similar changes were observed in low dose group except for PAH.In high dose group after 2 years of treatment,IGF-1,IGFBP-3 were significantly higher than those before the treatment and the difference was statistically significant (all P ＜ 0.05).Although the plasma levels of IGF-1 and IGFBP-3 in low dose group in 2 years of treatment were significantly higher than those before the treatment,the difference was not statistically significant (P ＞ 0.05).Compared with that before treatment,the added value of IGF-1 had a positive correlation with the added values of growth rate,HtSDS and PAH(r =0.567 4,0.652 4,0.584 3,0.499 8,all P ＜ 0.05).Similar observations were found in low dose group (r =0.437 1,0.405 6 and 0.501 1,all P ＜ 0.05).However,the added value of IGF-1 in low dose group had no correlation with PAH (r =0.200 8,P ＞ 0.05).Compared with that before treatment,2 groups had no differences in fasting and postprandial blood glucose,insulin,TSH,T3,T4 and glycosylated hemoglobin (all P ＞ 0.05).Conclusions Recombinant human growth hormone [0.20 IU/(kg · d)] may significantly increase the growth rate and PAH of short children born SGA,which is a safe and effective strategy for the treatment of short SGA.