Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2011, Vol. 33 ›› Issue (1): 1-4.doi: 10.3881/j.issn.1000-503X.2011.01.001

• Diagnosis and Treatment of Short Stature Forum •     Next Articles

Effect of Long term Glucocorticoid Treatment on Human Growth Hormone Secretion in Children and Adolescents and the Safety and Effectiveness of Recombinant Human Growth Hormone Treatment

LI Kang, ZHANG Dian xi, WU Qin yong, ZHU Hui juan, GONG Feng ying   

  1. Key Laboratory of Endocrinology of Ministry of Health, Department of Endocrinology,PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2010-10-08 Revised:2011-03-05 Online:2011-02-10 Published:2011-02-10

Abstract: Objective Long term glucocorticoid (prednisolone) treatment on human growth hormone (hGH) secretion in children and adolescents and to investigate the effectiveness and safety of the recombinant human growth hormone (rhGH) treatment. Methods Twelve patients (age: 10.4±1.2 years) who were treated in Peking Union Medical College Hospital from September 1999 to November 2009 were enrolled in this study. All of them had taken prednisolone with a dose of 0.5±2.0 mg/(kg·d) for 6~18 months. Two different hGH stimulating tests was done and their growth and development was evaluated at regular intervals. Seven patients were given rhGH with a dose of 0.1 U/(kg·d) for 6~12 months to improve their growth and development after half a year of prednisolone withdrawal when their disease conditions were improved. Results The growth speed of these 12 children decreased significantly during prednisolone treatment compared with before prednisolone treatment (1.2±0.3 cm/year vs.3.7±1.2 cm/year,P<0.05). Plasma hGH was under 10 ng/ml in 10 patients in two hGH exciting experiments. The abnormality of hGH secretion was significantly more remarkable in those with a prednisolone treatment course of >12 months than those with a 6~12 months course (P<0.05). However, no such significant difference was found between those with prednisolone dose of 0.5~1.0 mg/(kg·d) and those with 1.0~2.0 mg/(kg·d) (P>0.05). The growth speed of seven children who received rhGH therapy for half a year were increased from 2.2±0.1 cm/year to 7.8±0.5 cm/year (P<0.05), and then to 6.9±0.4 cm/year one year later. Conclusions The long-term glucocorticoid treatment can decrease the hGH secretion, and thus leads to short stature and agenesis. However, the rhGH replacement can safely and effectively improve growth and development in these children after their primary diseases are improved and glucocorticoids are withdrawn.

Key words: glucocorticoid, children, adolescent, human growth hormone, recombinant human growth hormone, short stature

CLC Number: