Clinical trial of PEG-rhGH in the treatment of children with idiopathic short stature
Objective To explore growth velocity(GV)and analyze its influencing factors in children with idiopathic short stature(ISS)after treatment with polyethylene glycol recombinant human growth hormone(PEG-rhGH).Methods The clinical data of children with ISS were retrospectively analyzed.All children were given subcutaneous injection of PEG-rhGH(0.16-0.17 mg·kg-1 each week)at periumbilical,lateral upper arm and thigh sites for 1 year.The differences in growth parameters before and after treatment were observed,and GV after treatment was recorded.The influencing factors of GV at 1 year after treatment were analyzed by multivariate stepwise linear regression analysis.Results Before and after 1 year of treatment,height(Ht)was(109.51±12.59)and(123.16±13.07)cm,height standard deviation scores(HtSDS)were-2.24±0.25 and-1.71±0.21,GV levels were(3.81±0.52)and(9.88±1.04)cm·year-1,levels of 25-hydroxy-vitamin-D[25(OH)D]were(27.19±3.14)and(33.05±3.46)ng·mL-1,levels of propeptide of type I procollagen(PINP)were(490.29±54.30)and(598.45±57.18)μg·L-1,levels of insulin-like growth factor-1(IGF-1)were(114.86±19.14)and(213.73±20.03)ng·mL-1,levels of insulin-like growth factor binding protein-3(IGFBP-3)were(6 817.27±716.30)and(7 230.39±721.45)ng·mL-1,the differences were statistically significant(all P<0.05).Before treatment,chronological age(CA),bone age(BA),bone age delay(BAD),bone age index(BAI)and mid-parental height(MPH)were(8.05±1.09)years,(7.14±1.01)years,(-0.98±0.18)years,0.86±0.12 and(167.31±5.73)cm,respectively.Pearson correlation analysis showed that GV level after treatment was negatively correlated with CA,BA and BAI before treatment,while positively correlated with BAD and MPH before treatment(P<0.05).The results of multivariate stepwise linear regression analysis showed that high levels of CA,BA and BAI before treatment were risk factors of low GV level after PEG-rhGH treatment,while high levels of BAD and MPH before treatment were protective factors.Conclusion GV response is good in ISS children with low age at the beginning of PEG-rhGH treatment and bone age.Genetic targeted height can affect GV after treatment.
polyethylene glycol recombinant human growth hormoneidiopathic short staturegrowth velocitybone age