Discontinuation of Growth Hormone (GH) Treatment during the Transition Phase Is an Important Factor Determining the Phenotype of Young Adults with Nonidiopathic Childhood-Onset GH Deficiency

作者：Koltowska Haggstrom Maria^*; Geffner Mitchell E; Jonsson Peter; Monson John P; Abs Roger; Hana Vaclav; Hoybye Charlotte; Wollmann Hartmut A

来源：Journal of Clinical Endocrinology & Metabolism, 2010, 95(6): 2646-2654.

DOI：10.1210/jc.2009-2013

Context: Little is known about the impact of childhood-onset GH deficiency (GHD), in particular the duration of GH cessation during the transition phase, on adult phenotype.
Objective: We investigated the association between the manifestations and management of GHD during childhood/adolescence and the clinical features of GHD in adulthood.
Design/Setting/Patients/Intervention: Patients with reconfirmed childhood-onset GHD who resumed GH treatment as adults were identified from two sequential databases (n = 313). The cohort was followed up longitudinally from GH start in childhood to reinitiation of treatment in adulthood and 1 yr beyond. Analyses were performed in the total cohort and in subgroups of patients with idiopathic GHD (IGHD) and non-IGHD. The cohorts were stratified based on duration of GH cessation (short, <= 2 yr; long, >2 yr).
Main Outcome Measures: Regimen of pediatric GH administration, duration of GH interruption, IGF-I SD score, lipid concentrations, and quality of life were measured.
Results: Mean duration of GH interruption was 4.4 yr. IGF-I SD score in adulthood was related to severity of childhood GHD. In non-IGHD patients, a longer duration of GH interruption was associated with a worse lipid profile (P < 0.0001). Non-IGHD patients who gained more height during childhood GH treatment reported better quality of life than those who gained less height (P < 0.05).
Conclusions: Pediatricians should tailor GH treatment, not only for its beneficial effect on growth but also for future health in adulthood. In adults with reconfirmed GHD, particularly those with non-IGHD, early recommencement of GH should be considered. (J Clin Endocrinol Metab 95: 2646-2654, 2010)

• 出版日期2010-6