Dynamic response of C-type natriuretic peptide and its aminoterminal propeptide (NTproCNP) to growth hormone treatment in children with short stature

作者：Olney Robert C^*; Salehi Parisa; Prickett Timothy C R; Lima John J; Espiner Eric A; Sikes Kaitlin M; Geffner Mitchell E

来源：Clinical Endocrinology, 2016, 85(4): 561-568.

DOI：10.1111/cen.13103

Objective C-type natriuretic peptide (CNP) and its aminoterminal propeptide (NTproCNP) are potential biomarkers of recombinant human growth hormone (rhGH) efficacy. The objective of this study was to describe the pharmacodynamics of plasma CNP and NTproCNP levels in response to rhGH treatment and to identify the optimal time of sampling after starting rhGH.
Design This was a prospective, observational study. Subjects were treated with rhGH for 1 year, with blood sampled at regular intervals.
Patients Eighteen prepubertal children, eight with low levels of GH on biochemical testing and ten with idiopathic short stature, completed the study.
Measurements Blood levels of CNP, NTproCNP, GH, insulinlike growth factor-I, leptin and bone-specific alkaline phosphatase were measured. Anthropometrics were obtained.
Results Plasma levels of both CNP and NTproCNP reached peak levels 7-28 days after starting rhGH treatment and then declined to intermediate levels through the first year. Plasma NTproCNP levels after 14 days trended towards a correlation with height velocity after 6 and 12 months of treatment. Unexpectedly, serum GH levels measured 2 and 28 days after starting rhGH correlated strongly with height velocity after 6 and 12 months of treatment.
Conclusions This study identified 14 days after starting rhGH treatment as the optimal time for assessing CNP and NTproCNP levels as biomarkers of rhGH efficacy. Additionally, we identified GH levels as a potential biomarker. Larger, prospective studies are now needed to test the clinical utility of these biomarkers.

• 出版日期2016-10