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Duration-specific association between plasma IGFBP7 levels and diabetic complications in patients with type 2 diabetes mellitus 2 型糖尿病患者血浆 IGFBP7 水平与糖尿病并发症持续时间的关系
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2024-02-21 DOI: 10.1016/j.ghir.2024.101574
Xiaoyan Zhu , Fei Liang , Jieyun Yin , Xiaoliang Li , Lai Jiang , Yan Gao , Yan Lu , Yihe Hu , Ningbin Dai , Jian Su , Zhuoqiao Yang , Mengxin Yao , Yue Xiao , Wenxin Ge , Yue Zhang , Yi Zhong , Jun Zhang , Ming Wu

Objective

Insulin-like growth factor binding protein 7 (IGFBP7) has a strong affinity to insulin. This study aimed to evaluate the relationship between IGFBP7 and complications among type 2 diabetes mellitus (T2DM) patients.

Design

A total of 1449 T2DM patients were selected from a cross-sectional study for disease management registered in the National Basic Public Health Service in Changshu, China, and further tested for their plasma IGFBP7 levels. Logistic regressions and Spearman's rank correlation analyses were used to explore the associations of IGFBP7 with diabetic complications and clinical characteristics, respectively.

Results

Among the 1449 included T2DM patients, 403 (27.81%) had complications. In patients with shorter duration (less than five years), the base 10 logarithms of IGFBP7 concentration were associated with T2DM complications, with an adjusted odds ratio (OR) of 2.41 [95% confidence interval (95%CI) = 1.06–5.48]; while in patients with longer duration (more than five years), plasma IGFBP7 levels were not associated with T2DM complications. Furthermore, in T2DM patients with shorter duration, those with two or more types of complications were more likely to have higher levels of IGFBP7.

Conclusion

IGFBP7 is positively associated with the risk of complication in T2DM patients with shorter duration.

目的胰岛素样生长因子结合蛋白7(IGFBP7)与胰岛素有很强的亲和力。设计从常熟市国家基本公共卫生服务项目疾病管理横断面研究中选取 1449 例 T2DM 患者,进一步检测其血浆 IGFBP7 水平。结果 在纳入的1449例T2DM患者中,403例(27.81%)有并发症。在病程较短(少于五年)的患者中,IGFBP7浓度的基10对数与T2DM并发症有关,调整后的比值比(OR)为2.41[95%置信区间(95%CI)=1.06-5.48];而在病程较长(五年以上)的患者中,血浆IGFBP7水平与T2DM并发症无关。结论IGFBP7与病程较短的T2DM患者的并发症风险呈正相关。
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引用次数: 0
Evaluation of growth hormone deficiency in women with unexplained infertility 评估不明原因不孕妇女的生长激素缺乏症
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ghir.2024.101571
Mehmet Serif Ortac , Aysa Hacioglu , Semih Zeki Uludag , Zuleyha Karaca , Kursad Unluhizarci , Fahrettin Kelestimur , Fatih Tanriverdi

Purpose

Growth hormone (GH) has been recognized to play a regulatory role in female reproduction. It has been reported that infertile GH deficient patients regained fertility after GH replacement. The frequency of GH deficiency is not established in patients diagnosed with unexplained infertility. Here, we aim to present the prevalence of GH deficieny in this patient group.

Methods

We included patients diagnosed with unexplained infertility throughout 18 months. Insulin tolerance test (ITT) and glucagon stimulation tests (GST) were performed and insufficient response to both tests was required for the diagnosis of GH deficiency.

Results

Twenty-five patients were included in the study, the mean age was 27.4 ± 4.5 years and the median duration of infertility was 60 months (min:14, max:120). Two patients were GH deficient according to GST and 14 to ITT. Two patients (8%) showed lack of response on both tests and were diagnosed with GH deficiency.

Conclusion

The rate of GH deficiency among women with unexplained infertility was 8% in this preliminary study. There is need for further studies with larger patient groups to verify the results.

目的生长激素(GH)被认为在女性生殖过程中发挥着调节作用。有报道称,缺乏 GH 的不孕症患者在补充 GH 后可恢复生育能力。在诊断为不明原因不孕症的患者中,GH缺乏症的发病率尚未确定。在此,我们旨在介绍 GH 缺乏症在这一患者群体中的发病率。结果25名患者被纳入研究,平均年龄为(27.4±4.5)岁,中位不孕时间为60个月(最小14个月,最大120个月)。根据 GST,2 名患者缺乏 GH,根据 ITT,14 名患者缺乏 GH。结论在这项初步研究中,不明原因不孕症妇女中的 GH 缺乏率为 8%。需要对更大的患者群体进行进一步研究,以验证研究结果。
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引用次数: 0
Insights from an advisory board: Facilitating transition of care into adulthood in brain cancer survivors with acquired pediatric growth hormone deficiency 咨询委员会的见解:促进后天性小儿生长激素缺乏症脑癌幸存者向成年期的护理过渡
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ghir.2024.101573
Craig Alter , Margaret Boguszewski , David Clemmons , Georgiana A. Dobri , Mitchell E. Geffner , Nicky Kelepouris , Bradley S. Miller , Richard Oh , Heidi Shea , Kevin C.J. Yuen

Objective

Children with growth hormone deficiency (GHD) face multiple challenges that can negatively impact the transition from pediatric to adult endocrinology care. For children with GHD resulting from brain cancer or its treatment, the involvement of oncology care providers and possible disease-related comorbidities add further complexity to this transition.

Design

An advisory board of pediatric and adult endocrinologists was convened to help better understand the unique challenges faced by childhood cancer survivors with GHD, and discuss recommendations to optimize continuity of care as these patients proceed to adulthood. Topics included the benefits and risks of growth hormone (GH) therapy in cancer survivors, the importance of initiating GH replacement therapy early in the patient's journey and continuing into adulthood, and the obstacles that can limit an effective transition to adult care for these patients.

Results/conclusions

Some identified obstacles included the need to prioritize cancer treatment over treatment for GHD, a lack of patient and oncologist knowledge about the full range of benefits provided by long-term GH administration, concerns about tumor recurrence risk in cancer survivors receiving GH treatment, and suboptimal communication and coordination (e.g., referrals) between care providers, all of which could potentially result in treatment gaps or even complete loss of follow-up during the care transition. Advisors provided recommendations for increasing education for patients and care providers and improving coordination between treatment team members, both of which are intended to help improve continuity of care to maximize the health benefits of GH administration during the critical period when childhood cancer survivors transition into adulthood.

目的生长激素缺乏症(GHD)患儿面临着多种挑战,这些挑战可能会对从儿科内分泌治疗向成人内分泌治疗的过渡产生负面影响。设计召集了一个由儿科和成人内分泌专家组成的咨询委员会,以帮助更好地了解患有生长激素缺乏症的儿童癌症幸存者所面临的独特挑战,并讨论在这些患者进入成年期时优化护理连续性的建议。讨论的主题包括生长激素 (GH) 治疗对癌症幸存者的益处和风险、在患者早期开始 GH 替代治疗并持续到成年的重要性,以及可能限制这些患者有效过渡到成人护理的障碍。结果/结论已发现的一些障碍包括:需要优先考虑癌症治疗而不是 GHD 治疗;患者和肿瘤学家缺乏对长期服用 GH 所带来的全部益处的了解;担心接受 GH 治疗的癌症幸存者的肿瘤复发风险;以及医疗服务提供者之间的沟通和协调(如转诊)不够理想、转诊),所有这些都有可能导致治疗缺口,甚至在治疗过渡期间完全失去随访。顾问们建议加强对患者和护理提供者的教育,并改善治疗团队成员之间的协调,这两点都旨在帮助改善护理的连续性,以便在儿童癌症幸存者向成年过渡的关键时期最大限度地发挥GH治疗对健康的益处。
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引用次数: 0
Growth hormone directly stimulates GATA2 expression 生长激素直接刺激 GATA2 的表达
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2024-02-01 DOI: 10.1016/j.ghir.2024.101572
Mana Mitsutani , Midori Matsushita , Mei Yokoyama , Ayumu Morita , Hiromi Hano , Tomomi Fujikawa , Tetsuya Tagami , Kenji Moriyama

Objective

GATA2 is a key transcription factor involved in the differentiation and determination of thyrotrophs and gonadotrophs in pituitary and hematopoietic development. However, studies on the upstream ligands of the GATA2 signal transduction pathway have been limited. To identify upstream ligands, we examined growth hormone (GH) as a plausible stimulator.

Design

We evaluated GH-induced GATA2 expression in murine TtT/GF thyrotrophic pituitary tumor cells and its direct impact on the GHR/JAK/STAT5 pathway using a combination of a reporter assay, real-time quantitative polymerase chain reaction, and western blotting.

Results

GATA2 expression increased with activated STAT5B in a dose-dependent manner and was inhibited by a STAT5 specific inhibitor. Moreover, we found functional STAT5B binding site consensus sequences at −359 bp in the GATA2 promoter region.

Conclusion

These findings suggest that GH directly stimulates GATA2 via the GHR/JAK/STAT pathway and participates in various developmental phenomena mediated by GATA2.

目的GATA2是一种关键的转录因子,参与垂体和造血发育过程中甲状腺和促性腺激素的分化和决定。然而,有关 GATA2 信号转导通路上游配体的研究还很有限。为了确定上游配体,我们将生长激素(GH)作为一种可能的刺激物进行了研究。结果GATA2的表达以剂量依赖的方式随活化的STAT5B而增加,并受到STAT5特异性抑制剂的抑制。此外,我们在 GATA2 启动子区域的 -359 bp 处发现了功能性 STAT5B 结合位点共识序列。
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引用次数: 0
Growth hormone therapy for children with Duchenne muscular dystrophy and glucocorticoid induced short stature 生长激素治疗Duchenne肌营养不良和糖皮质激素诱导的矮小儿童
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ghir.2023.101558
Eran Lavi , Amitay Cohen , Abdulsalam Abu Libdeh , Reuven Tsabari , David Zangen , Talya Dor

Objective

To evaluate the outcome of recombinant human Growth Hormone (rhGH) therapy in patients with Duchene Muscular Dystrophy (DMD) and glucocorticoid treatment with compromised growth.

Design

Four DMD patients on Deflzacort 0.6–0.85 mg/kg/day or prednisolone 0.625 mg/kg/day recieved rhGH (0.24 mg/kg/week) for 6–18 months. Primary outcomes were Growth velocity and Height for age Z-scores (Height SD).

Results

Growth velocity increased from 0 to 3.25 cm/year prior to GH therapy to 3.3–7.8 cm/year over a period of 6–18 months. The typical Height SD decline in DMD was reversed in two patients and blunted in one. No adverse events or deterioration in cardiac or respiratory parameters were associated with the rhGH treatment.

Conclusions

rhGH appears to be safe and efficient in promoting growth of patients with glucocorticoid induced growth failure in DMD.

目的评价重组人生长激素(rhGH)治疗杜氏肌营养不良(DMD)和糖皮质激素治疗生长障碍的疗效。设计4名DMD患者接受0.6–0.85 mg/kg/天的替扎卡或0.625 mg/kg/天泼尼松治疗,接受rhGH(0.24 mg/kg/周)治疗6–18个月。主要结果是生长速度和身高Z评分(Height SD)。结果生长速度从生长激素治疗前的0至3.25 cm/年增加到6至18个月的3.3至7.8 cm/年。DMD的典型身高SD下降在两名患者中逆转,在一名患者中减弱。rhGH治疗无不良事件或心脏或呼吸参数恶化。结论srhGH对糖皮质激素诱导的DMD生长衰竭患者的生长具有安全有效的促进作用。
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引用次数: 0
Insulin-like growth factor (IGF) performance in ovarian function and applications in reproductive biotechnologies 胰岛素样生长因子(IGF)在卵巢功能中的表现及在生殖生物技术中的应用
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ghir.2023.101561
Tathyana Benetis Piau, Aline de Queiroz Rodrigues, Fernanda Paulini

The role of the insulin-like growth factor (IGF) system has attracted close attention. The activity of IGF binding proteins (IGFBPs) within the ovary has not been fully elucidated to date. These proteins bind to IGF with an equal, or greater, affinity than to the IGF1 receptor, thus being in the main position to regulate IGF signalling, in addition to extending the half-life of IGFs within the bloodstream and promoting IGF storage in specific tissue niches. IGF1 has an important part in cell proliferation, differentiation and apoptosis. Considering the importance of IGFs in oocyte maturation, this review sought to elucidate aspects including: IGF production mechanisms; constituent members of their family and their respective functions; the role that these factors play during folliculogenesis, together with their functions during oocyte maturation and apoptosis, and their performance during luteal development. This review also explores the role of IGFs in biotechnological applications, focusing specifically on animal genetic gain.

胰岛素样生长因子(IGF)系统的作用引起了人们的密切关注。迄今为止,IGF 结合蛋白(IGFBPs)在卵巢中的活性尚未完全阐明。这些蛋白与 IGF 的结合亲和力与 IGF1 受体的结合亲和力相同或更高,因此,除了延长 IGF 在血液中的半衰期和促进 IGF 在特定组织龛位中的储存外,它们还处于调节 IGF 信号的主要位置。IGF1 在细胞增殖、分化和凋亡中发挥着重要作用。考虑到 IGFs 在卵母细胞成熟过程中的重要性,本综述试图阐明包括以下方面在内的问题:IGF 的产生机制;IGF 家族的组成成员及其各自的功能;这些因子在卵泡生成过程中的作用,以及它们在卵母细胞成熟和凋亡过程中的功能和它们在黄体发育过程中的表现。本综述还探讨了 IGF 在生物技术应用中的作用,尤其侧重于动物基因增殖。
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引用次数: 0
A combined top-down and bottom-up LC-HRMS/MS method for the quantification of human growth hormone in plasma and serum 自上而下和自下而上相结合的LC-HRMS/MS定量血浆和血清中生长激素的方法。
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ghir.2023.101560
Sophia Krombholz , Andreas Thomas , Philippe Delahaut , Martin Bidlingmaier , Katharina Schilbach , Geoffrey Miller , Mario Thevis

Objective

The precise and accurate quantification of human growth hormone (GH) in plasma/ serum is crucial for the diagnosis and treatment of diseases like GH deficiency or acromegaly. However, the ligand-binding assays (LBAs) currently used for routine testing show considerable methodological variability. Here, we present a complementary, combined top-down and bottom-up LC-MS-based method to quantify (intact) GH in plasma and serum, which concurrently provides a basis for a MS-based analysis of GH in doping controls.

Design

Extraction of GH from plasma/ serum was accomplished by protein precipitation, followed by an immunocapture step using protein A-coupled magnetic beads and a polyclonal anti-GH antibody. The intact protein was subsequently analyzed top-down on a 2D-LC-HRMS/MS system. In addition, sample extracts were digested with trypsin and analyzed for signal peptides corresponding to ‘total’, 22 kDa and 20 kDa GH (bottom-up). Both assays were validated according to current guidelines and compared to the GH isoform differential immunoassay used in routine doping control analysis. GH concentrations in serum samples of healthy adults, patients with acromegaly, and in samples obtained after administration of recombinant GH were analyzed as proof-of-principle.

Results

The intact monomeric 22 kDa isoform of GH was selectively quantified in a representative working range of 0.5 to 10 ng/ml by top-down LC-HRMS/MS. Subsequent bottom-up analysis provided additional data on ‘total’ and 20 kDa GH. Top-down and bottom-up assay results for the 22 kDa isoform correlated well with the corresponding immunoassay results (R2 > 0.95). For a possible application of the method in an anti-doping context, the ratio between 22 kDa and ‘total’ GH was evaluated, indicating differences between the various donor groups, but only with limited significance.

Conclusion

The top-down and bottom-up LC-HRMS/MS method developed here presents a valuable tool for the quantification of GH in plasma/ serum complementary to established LBAs used at present in clinical measurements. Albeit the examination of the GH isoform proportions by the LC-MS method does not yet allow for the assessment of GH abuse, the obtained findings provide an important basis to enable LC-MS-based GH analysis of doping control samples in the future.

目的:准确、准确地测定血浆/血清中生长激素(GH)的含量,对GH缺乏症或肢端肥大症等疾病的诊断和治疗具有重要意义。然而,目前用于常规检测的配体结合试验(LBAs)显示出相当大的方法可变性。在这里,我们提出了一种互补的,结合自上而下和自下而上的lc - ms的方法来定量(完整的)血浆和血清中的生长激素,同时为兴奋剂控制中的生长激素的ms分析提供了基础。设计:通过蛋白沉淀从血浆/血清中提取生长激素,然后使用蛋白a偶联磁珠和多克隆抗生长激素抗体进行免疫捕获步骤。随后在2D-LC-HRMS/MS系统上自上而下分析完整蛋白。此外,用胰蛋白酶消化样品提取物,并分析对应于“total”、22 kDa和20 kDa GH的信号肽(自下而上)。两种检测方法均根据现行指南进行验证,并与常规兴奋剂控制分析中使用的生长激素异构体差异免疫测定法进行比较。对健康成人、肢端肥大症患者和重组生长激素治疗后获得的血清样本中的生长激素浓度进行了分析,作为原理证明。结果:采用自顶向下LC-HRMS/MS,在0.5 ~ 10 ng/ml的代表性工作范围内,选择性地定量了生长激素完整的22 kDa单体异构体。随后的自下而上分析提供了“总”和20 kDa GH的额外数据。22 kDa亚型自上而下和自下而上的分析结果与相应的免疫分析结果具有良好的相关性(R2 > 0.95)。对于该方法在反兴奋剂背景下的可能应用,评估了22 kDa和“总”生长激素之间的比率,表明了不同供体组之间的差异,但意义有限。结论:本文建立的自顶向下和自底向上LC-HRMS/MS方法是一种有价值的定量血浆/血清生长激素的工具,与目前临床测量中使用的已建立的LBAs相补充。虽然通过LC-MS方法检查GH同型比例还不能评估GH滥用,但所获得的发现为将来使用LC-MS对兴奋剂控制样品进行GH分析提供了重要的基础。
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引用次数: 0
Comparison of hyperoxia or normoxia resolution of intermittent hypoxia and intermittent hyperoxia episodes on liver histopathology, IGF-1, IGFBP-3, and GHBP in neonatal rats 新生儿大鼠肝组织病理学、IGF-1、IGFBP-3和GHBP的高氧或常氧解决间歇性缺氧和间歇性高氧发作的比较
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.ghir.2023.101559
Charles L. Cai , Matthew Marcelino , Jacob V. Aranda , Kay D. Beharry

Objective

Extremely low gestational age neonates requiring oxygen therapy for chronic lung disease experience repeated fluctuations in arterial oxygen saturation, or intermittent hypoxia (IH), during the first few weeks of life. These events are associated with a high risk for reduced growth, hypertension, and insulin resistance in later life. This study tested the hypothesis that IH, or intermittent hyperoxia have similar negative effects on the liver; somatic growth; and liver insulin-like growth factor (IGF)-I, IGF binding protein (BP)-3, and growth hormone binding protein (GHBP), regardless of resolution in normoxia or hyperoxia between episodes.

Design

Newborn rats on the first day of life (P0) were exposed to two IH paradigms: 1) hyperoxia (50% O2) with brief hypoxia (12% O2); or 2) normoxia (21% O2) with hypoxia (12% O2); intermittent hypoxia (50% O2/21% O2); hyperoxia only (50% O2); or room air (RA, 21% O2). Pups were euthanized on P14 or placed in RA until P21. Controls remained in RA from P0-P21. Growth, liver histopathology, apoptosis, IGFI, IGFBP-3, and GHBP were assessed.

Results

Pathological findings of the liver hepatocytes, including cellular swelling, steatosis, apoptosis, necrosis and focal sinusoid congestion were seen in the IH and intermittent hyperoxia groups, and were particularly severe in the 21–12% O2 group during exposure (P14) with no significant improvements during recovery/reoxygenation (P21). These effects were associated with induction of HIF, and reductions in liver IGFI, IGFBP-3, and GHBP.

Conclusions

Exposure to IH or intermittent hyperoxia during the first few weeks of life regardless of resolution in RA or hyperoxia is detrimental to the immature liver. These findings may suggest that interventions to prevent frequent fluctuations in oxygen saturation during early neonatal life remain a high priority.

目的因慢性肺病需要氧气治疗的极低胎龄新生儿在生命的最初几周内,动脉血氧饱和度或间歇性缺氧(IH)会反复波动。这些事件与生长发育迟缓、高血压和晚年胰岛素抵抗的高风险有关。这项研究验证了IH或间歇性高氧对肝脏有类似负面影响的假设;体细胞生长;和肝胰岛素样生长因子(IGF)-I、IGF结合蛋白(BP)-3和生长激素结合蛋白(GHBP),无论发作之间的常氧或高氧消退。设计新生大鼠在出生第一天(P0)暴露于两种IH模式:1)高氧(50%O2)伴短暂缺氧(12%O2);或2)常氧(21%O2)伴缺氧(12%O2);间歇性缺氧(50%O2/21%O2);仅高氧(50%O2);或室内空气(RA,21%O2)。幼犬在P14被安乐死或置于RA中直到P21。对照组从P0-P21起仍处于RA。评估生长、肝脏组织病理学、细胞凋亡、IGFI、IGFBP-3和GHBP。结果IH组和间歇性高氧组肝细胞的病理学表现,包括细胞肿胀、脂肪变性、凋亡、坏死和局灶性血窦充血,尤其是暴露期间21-12%O2组(P14),在恢复/复氧期间(P21)没有显著改善。这些作用与HIF1α的诱导以及肝脏IGFI、IGFBP-3和GHBP的减少有关。结论无论RA或高氧消退,在生命的最初几周暴露于IH或间歇性高氧对未成熟肝脏都是有害的。这些发现可能表明,预防新生儿早期血氧饱和度频繁波动的干预措施仍然是当务之急。
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引用次数: 0
Response to growth hormone therapy in ring chromosome 15: Review and evidence from a new case on possible beneficial effect in neurodevelopment 15号环染色体对生长激素治疗的反应:回顾和来自一个可能对神经发育有益的新病例的证据
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.ghir.2023.101550
Selmen Wannes , Ikram El Ahmer , Khouloud Rjiba , Nessrine Jemmali , Hamza Haj Abdallah , Rania Bel Haj , Asma Achour , Hassan Bouzidi , Ali Saad , Soumaya Mougou , Bahri Mahjoub

Type 1 Insulin-like Growth Factor Receptor(IGF1R) plays a fundamental role in normal growth and development. Its disruption is usually characterized by severe intrauterine and postnatal growth retardation, microcephaly and neurodevelopmental delay.The efficacy of recombinant human growth hormone treatment remains a challenge for children with IGF1 resistance and pathogenic mutations of IGF1R, with limited data in patients carrying the most severe form of IGF1R defect, the ring chromosome 15.

Subject and method

We tested a high dose of rhGH in a new patient with ring chromosome 15, as confirmed by karyotype and CGH array. We performed a systematic review, and all published r(15) syndrome cases treated by growth hormone(GH) up to April 2023 were searched, and their response to GH therapy was recorded and summarized.

Results

Twelve patients with ring chromosome 15 received GH therapy according to a literature review. We expand the spectrum by the 13th case treated by GH, and we report an impressive improvement in intellectual performance and progressive catch-up growth after 5 and 20 months of follow-up. By introducing our new case in the analysis, the sex ratio was 3:10, and GH therapy was started at the age of 5.5 (3/9.4) (years) for an age of diagnosis of 4.75 (1.3/9.5) (years). The height before GH therapy was −5.1(−5.9/−4.1) SDS. The median duration of treatment was 1.7(0.9/2) (years), with a median height gain of 1(0.3/1.8) SDS and an improvement in growth velocity of 4.1(2.8/5.3) (cm/year).

Conclusion

GH seems to be effective for r(15) syndrome patients with short stature.

1型胰岛素样生长因子受体(IGF1R)在正常生长发育中起着重要作用。其破坏通常以严重的宫内和产后生长迟缓、小头畸形和神经发育迟缓为特征。对于IGF1耐药性和IGF1R致病性突变的儿童来说,重组人生长激素治疗的疗效仍然是一个挑战,在携带最严重形式的IGF1R缺陷(环染色体15)的患者中,数据有限。受试者和方法我们在一名新的环染色体15患者中测试了高剂量的rhGH,核型和CGH阵列证实了这一点。我们进行了一项系统综述,检索了截至2023年4月所有已发表的生长激素(GH)治疗的r(15)综合征病例,并记录和总结了他们对GH治疗的反应。结果对12例15号环状染色体患者进行GH治疗。我们在第13例接受GH治疗的病例中扩大了这一范围,我们报告在5个月和20个月的随访后,智力表现和渐进性追赶生长有了显著改善。通过在分析中介绍我们的新病例,性别比为3:10,生长激素治疗在5.5岁(3/9.4)(岁)时开始,诊断年龄为4.75岁(1.3/9.5)(年)。GH治疗前的身高为−5.1(−5.9/−4.1)SDS。中位治疗时间为1.7(0.9/2)(年),中位身高增加1(0.3/1.8)SDS,生长速度改善4.1(2.8/5.3)(cm/年)。
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引用次数: 0
Assessment of anterior pituitary reserve capacity based on growth hormone response to growth hormone-releasing peptide-2 test in the elderly 基于生长激素对生长激素释放肽-2试验反应的老年人垂体前叶储备能力评估
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.ghir.2023.101545
Shinichiro Teramoto , Shigeyuki Tahara , Yujiro Hattori , Akihide Kondo , Akio Morita

Objective

The growth hormone (GH)-releasing peptide-2 (GHRP-2) test is relatively safe among endocrine stimulation tests for the elderly. We investigated whether anterior pituitary function in elderly patients could be assessed on the basis of GH response to the GHRP-2 test.

Design

Sixty-five elderly patients aged 65 years and older with non-functioning pituitary neuroendocrine tumor (PitNET) who underwent pituitary surgery and preoperative endocrine stimulation tests were classified into the “GH normal group” and “GH deficiency group” based on GH response to the GHRP-2 test. The baseline characteristics and anterior pituitary function were compared between the groups.

Results

Thirty-two patients were assigned to the GH normal group and 33 to the GH deficiency group. The cortisol and adrenocorticotropic hormone (ACTH) results in the corticotropin-releasing hormone test were significantly higher in the GH normal group than in the GH deficiency group (p < 0.001). The relationship between the cortisol and ACTH results and the GH response revealed significant correlations (p < 0.001). In addition, receiver operating characteristic curve analysis identified that the optimal cut-off point for a peak GH level in the correlation between adrenocortical function and GH response to the GHRP-2 test was 8.08 ng/mL (specificity 0.868, sensitivity 0.852).

Conclusion

The present study indicated that adrenocortical function was significantly correlated with GH response to the GHRP-2 test in elderly patients before pituitary surgery. For elderly patients with non-functioning PitNET, GH response to the GHRP-2 test may support in diagnosing adrenocortical insufficiency.

目的在老年人内分泌刺激试验中,生长激素释放肽-2(GHRP-2)试验是比较安全的。我们研究了是否可以根据GH对GHRP-2测试的反应来评估老年患者的垂体前叶功能。设计65例65岁及以上患有功能性垂体神经内分泌瘤(PitNET)的老年患者接受垂体手术和术前内分泌刺激测试,根据GH对GHRP-2测试的反应,将其分为“GH正常组”和“GH缺乏组”。比较两组的基线特征和垂体前叶功能。结果32例患者被分为生长激素正常组,33例被分为GH缺乏组。促皮质激素释放激素测试中的皮质醇和促肾上腺皮质激素(ACTH)结果在GH正常组中显著高于GH缺乏组(p<;0.001)。皮质醇和促皮质激素结果与GH反应之间的关系显示出显著相关性(p<)。此外,受试者工作特性曲线分析表明,在肾上腺皮质功能和GH对GHRP-2试验的反应之间的相关性中,GH峰值水平的最佳截止点为8.08ng/mL(特异性0.868,敏感性0.852)。结论本研究表明,老年人肾上腺皮质功能与GH对GHRP-2试验的反应显著相关垂体手术前的患者。对于PitNET功能不全的老年患者,GH对GHRP-2测试的反应可能有助于诊断肾上腺皮质功能不全。
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Growth Hormone & Igf Research
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