SOMATOTROPIC FUNCTION IN SHORT STATURE - EVALUATION BY INTEGRATED AUXOLOGICAL AND HORMONAL INDEXES IN 214 CHILDREN

被引:28
作者
DAMMACCO, F
BOGHEN, MF
CAMANNI, F
CAPPA, M
FERRARI, C
GHIGO, E
GIORDANO, G
LOCHE, S
MINUTO, F
MUCCI, M
MULLER, EE
机构
[1] OSPED MICROCITEMICO, SERV ENDOCRINOL PEDIAT, CAGLIARI, ITALY
[2] UNIV GENOA, DISEM, CATTEDRA FISIOPATOL ENDOCRINA, I-16126 GENOA, ITALY
[3] UNIV GENOA, DISEM, CATTEDRA ENDOCRINOL, I-16126 GENOA, ITALY
[4] UNIV TURIN, DIV ENDOCRINOL, DIPARTIMENTO FISIOPATOL CLIN, I-10124 TURIN, ITALY
[5] IRCCS, OSPED PEDIAT BAMBINO GESU, DIV ENDOCRINOL, ROME, ITALY
[6] UNIV MILAN, KABIPHARMACIA PIERREL, I-20122 MILAN, ITALY
[7] OSPED FATEBENEFRATELLI OFTALMICO, SERV ENDOCRINOL, MILAN, ITALY
[8] UNIV MILAN, DIPARTIMENTO FARMACOL, I-20122 MILAN, ITALY
关键词
D O I
10.1210/jc.77.1.68
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
GH secretion was evaluated in 214 children and adolescents (age, 5-16 yr; 160 males and 54 females) with short stature (height, less-than-or-equal-to 5th percentile) by assessing mean spontaneous overnight GH concentration (normal values, greater-than-or-equal-to 3 and 3.9 mug/L for prepubertal and pubertal subjects, respectively) and responsiveness to stimulation with GH-releasing hormone combined with pyridostigmine (normal peak values, greater-than-or-equal-to 20 mug/L). Plasma insulin-like growth factor-I (IGF-I) was also measured. According to their GH secretory status, children were grouped as follows: group I, 154 subjects with normal spontaneous and stimulated GH (43 slow-growing and 111 normally growing); group II, 39 subjects with low spontaneous, but normal stimulated, GH (27 slow-growing and 12 normally growing); group III, 18 slow-growing subjects with low spontaneous and stimulated GH; and group IV, 3 subjects with normal spontaneous, but low stimulated, GH. The following conclusions were drawn. 1) Forty-five slow-growing subjects (21% of the total sample) had GH deficiency; 27 (12.6%) belonged to group II (with a preserved GH pituitary reserve, denoting a hypothalamic dysfunction) and 18 (8.4%) to group III (with a reduced GH pituitary reserve). 2) Forty-three slow-growing children in group I had normal GH secretion but low mean IGF-I, which may indicate nutritional problems or a biologically hypoactive GH molecule. 3) The remaining 111 subjects in group I (52%), with normal growth rate, but low mean parental height, were considered as having familial and/or constitutional short stature. GH responses after pyridostigmine plus GH-releasing hormone were normal in all children with a normal growth rate. These findings show that besides clinical evaluation, the assessment of spontaneous GH secretion, GH pituitary reserve, and IGF-I concentration allows proper pathophysiological characterization of short stature. By this approach, the frequency of GH deficiency in our sample was higher than commonly thought.
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收藏
页码:68 / 72
页数:5
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