Purpose: To assess the growth hormone(GH) response to the Wingate anaerobic test(WAn T) among children with short stature and suspected GH deficiency. We hypothesized that the GH response to the WAn T would be similar...Purpose: To assess the growth hormone(GH) response to the Wingate anaerobic test(WAn T) among children with short stature and suspected GH deficiency. We hypothesized that the GH response to the WAn T would be similar to the GH response to a commonly used pharmacologic provocation test.Methods: Ten children(6 males and 4 females, age range 9.0–14.9 years) participated in the study. Each participant performed 2 tests: a standard all-out WAn T, cycling for 30 s against constant resistance, and a standardized pharmacologic test(clonidine or glucagon). Blood samples for GH were collected before and 10, 30, 45, and 60 min after the beginning of exercise. In addition, we collected pre-and post-exercise blood lactate levels.Results: There was a significant increase in GH levels after the WAn T, yet in 9 of 10 participants, this increase was below the threshold for GH sufficiency. Peak GH after the WAn T was significantly lower compared to the pharmacologic GH provocation tests(with 9 of 10 demonstrating GH-sufficient response).Conclusion: The traditional WAn T cannot be used as a GH provocation test. Further research is needed to develop anaerobic exercise protocols sufficient to promote GH secretion.展开更多
Short stature is a clinical challenge in the daily practice of pediatric endocrinology, regarding the several technical, cultural and economic factors associated with its approach. This article intends to review the p...Short stature is a clinical challenge in the daily practice of pediatric endocrinology, regarding the several technical, cultural and economic factors associated with its approach. This article intends to review the physiology of growth hormone secretion, the endocrine regulation of human growth and the clinical aspects of the diagnosis and treatment of short stature. It specifically analyses the treatment of short stature with growth hormone, along with its side effects, cost/benefit analysis and possible risks. A clinical case from a medical school is also described, intending a better understanding of this frequent ambulatory situation in endocrinology and pediatrics.展开更多
Ectopic posterior pituitary is a disruption in the normal embryogenesis and is one of the rare but common causes of pituitary dwarfism. We report the MRI and clinical findings of a 13.5-year-old Saudi boy who was refe...Ectopic posterior pituitary is a disruption in the normal embryogenesis and is one of the rare but common causes of pituitary dwarfism. We report the MRI and clinical findings of a 13.5-year-old Saudi boy who was referred to the endocrine outpatient clinic with no significant complaints except for fatigue, exercise intolerance and short stature. Physical examination revealed short stature (below 2nd centile) with normal body proportion without any dysmorphic features and prepubertal secondary sexual characteristics and genitalia. Hormonal profile revealed: low thyroxine level, low gonadotrophins, low testosterone, low cortisol and blunted growth hormone (GH) response to insulin induced hypoglycaemia. Bone age was of 5 years old. The MRI result concluded with a diagnosis of ectopic posterior pituitary. A diagnosis of posterior pituitary ectopia (PPE) with panhypopituitarism was made.展开更多
目的:分析不同体重指数(body mass index,BMI)的特发性矮小症(idiopathic short stature,ISS)患儿在重组人生长激素(recombinant human growth hormone,rhGH)治疗下的疗效差异及安全性。方法:选取于河北北方学院附属第一医院接受rhGH治...目的:分析不同体重指数(body mass index,BMI)的特发性矮小症(idiopathic short stature,ISS)患儿在重组人生长激素(recombinant human growth hormone,rhGH)治疗下的疗效差异及安全性。方法:选取于河北北方学院附属第一医院接受rhGH治疗的ISS患儿为研究对象,根据7岁以下儿童生长标准及中国6~18岁学龄儿童青少年性别、年龄、体质指数、超重与肥胖界值,将ISS患儿分为BMI正常组、超重组、肥胖组,测定三组患儿治疗前、治疗3个月及6个月后的身高(height,Ht)、BMI、生长速率(growth velocity,GV)、身高标准差积分(height standard deviation score,HtSDS)、胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(insulin like growth factor binding-protein-3,IGFBP-3)、空腹血糖(fasting blood glucose,FBG)、甲状腺功能及肝功能。结果:三组ISS患儿在rhGH治疗后Ht、GV、HtSDS、IGF-1、IGFBP-3均较治疗前增加(P<0.05)。BMI正常组患儿Ht、GV和HtSDS增长量明显高于超重组及肥胖组(P<0.05),超重组与肥胖组相比无明显差异(P>0.05)。BMI正常组患儿在治疗6个月后BMI较治疗前增加(P<0.05),而超重组及肥胖组BMI均较前下降(P<0.05)。rhGH治疗对FBG、甲状腺功能、肝功能无明显影响。结论:rhGH能明显提高ISS患儿的Ht、HtSDS、GV、IGF-1、IGFBP-3水平,BMI正常的ISS患儿的疗效明显好于超重组及肥胖组,超重及肥胖ISS患儿疗效无明显差异,rhGH治疗具有较好的安全性。展开更多
基金supported in part by grants from The Meir Medical Center Research Authority and Ferring Israel
文摘Purpose: To assess the growth hormone(GH) response to the Wingate anaerobic test(WAn T) among children with short stature and suspected GH deficiency. We hypothesized that the GH response to the WAn T would be similar to the GH response to a commonly used pharmacologic provocation test.Methods: Ten children(6 males and 4 females, age range 9.0–14.9 years) participated in the study. Each participant performed 2 tests: a standard all-out WAn T, cycling for 30 s against constant resistance, and a standardized pharmacologic test(clonidine or glucagon). Blood samples for GH were collected before and 10, 30, 45, and 60 min after the beginning of exercise. In addition, we collected pre-and post-exercise blood lactate levels.Results: There was a significant increase in GH levels after the WAn T, yet in 9 of 10 participants, this increase was below the threshold for GH sufficiency. Peak GH after the WAn T was significantly lower compared to the pharmacologic GH provocation tests(with 9 of 10 demonstrating GH-sufficient response).Conclusion: The traditional WAn T cannot be used as a GH provocation test. Further research is needed to develop anaerobic exercise protocols sufficient to promote GH secretion.
文摘Short stature is a clinical challenge in the daily practice of pediatric endocrinology, regarding the several technical, cultural and economic factors associated with its approach. This article intends to review the physiology of growth hormone secretion, the endocrine regulation of human growth and the clinical aspects of the diagnosis and treatment of short stature. It specifically analyses the treatment of short stature with growth hormone, along with its side effects, cost/benefit analysis and possible risks. A clinical case from a medical school is also described, intending a better understanding of this frequent ambulatory situation in endocrinology and pediatrics.
文摘Ectopic posterior pituitary is a disruption in the normal embryogenesis and is one of the rare but common causes of pituitary dwarfism. We report the MRI and clinical findings of a 13.5-year-old Saudi boy who was referred to the endocrine outpatient clinic with no significant complaints except for fatigue, exercise intolerance and short stature. Physical examination revealed short stature (below 2nd centile) with normal body proportion without any dysmorphic features and prepubertal secondary sexual characteristics and genitalia. Hormonal profile revealed: low thyroxine level, low gonadotrophins, low testosterone, low cortisol and blunted growth hormone (GH) response to insulin induced hypoglycaemia. Bone age was of 5 years old. The MRI result concluded with a diagnosis of ectopic posterior pituitary. A diagnosis of posterior pituitary ectopia (PPE) with panhypopituitarism was made.
文摘目的:分析不同体重指数(body mass index,BMI)的特发性矮小症(idiopathic short stature,ISS)患儿在重组人生长激素(recombinant human growth hormone,rhGH)治疗下的疗效差异及安全性。方法:选取于河北北方学院附属第一医院接受rhGH治疗的ISS患儿为研究对象,根据7岁以下儿童生长标准及中国6~18岁学龄儿童青少年性别、年龄、体质指数、超重与肥胖界值,将ISS患儿分为BMI正常组、超重组、肥胖组,测定三组患儿治疗前、治疗3个月及6个月后的身高(height,Ht)、BMI、生长速率(growth velocity,GV)、身高标准差积分(height standard deviation score,HtSDS)、胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(insulin like growth factor binding-protein-3,IGFBP-3)、空腹血糖(fasting blood glucose,FBG)、甲状腺功能及肝功能。结果:三组ISS患儿在rhGH治疗后Ht、GV、HtSDS、IGF-1、IGFBP-3均较治疗前增加(P<0.05)。BMI正常组患儿Ht、GV和HtSDS增长量明显高于超重组及肥胖组(P<0.05),超重组与肥胖组相比无明显差异(P>0.05)。BMI正常组患儿在治疗6个月后BMI较治疗前增加(P<0.05),而超重组及肥胖组BMI均较前下降(P<0.05)。rhGH治疗对FBG、甲状腺功能、肝功能无明显影响。结论:rhGH能明显提高ISS患儿的Ht、HtSDS、GV、IGF-1、IGFBP-3水平,BMI正常的ISS患儿的疗效明显好于超重组及肥胖组,超重及肥胖ISS患儿疗效无明显差异,rhGH治疗具有较好的安全性。
