Correlation Between Recombinant Human Growth Hormone Therapy And Myopia In Children With Dwarfism

Objective To retrospectively analyze the height,eyeball development and the expression level of serum insulin-like growth factor-I in patients with dwarfism during the treatment with recombinant human growth hormone,and explore whether the treatment with recombinant human growth hormone can promote the occurrence and development of myopia and the possible mechanism.Methods From January 2020 to August 2022,61 children with dwarfism aged 6-10 years who visited the Children’s Endocrinology Department of Cixi Maternal and Child Health Hospital and were followed up in the ophthalmic clinic of our hospital for a long time were selected,and 50 children with dwarfism who met the study inclusion conditions were included in the study.Among them,30 were treated with recombinant human growth hormone(rhGH)on the basis of conservative treatment to form a rhGH treatment group,The other 20 people received only conservative treatment to form a conservative treatment group.At the same time,30 children with normal growth and development and no myopia were randomly selected as the normal control group.The initial examination data of the three groups were summarized and analyzed before the study.After the start of treatment,the eye parameters,height,serum IGF-I concentration and other data of the short stature rhGH treatment group,the short stature conservative treatment group and the normal control group at the 6th,12th and 18th months after the start of treatment were recorded and analyzed in groups.Excel was used to establish a unified database for preliminary statistical classification of data,and later statistical software SPSS 17.0 was used to conduct statistical analysis of all data to explore whether the use of recombinant human growth hormone in children with dwarfism would lead to the occurrence and development of myopia.Results 1.The ocular axis of the children with dwarfism was shorter than that of the normal children(p=0.004 for the right eye,p=0.001 for the left eye).However,there was no significant difference between the two in terms of equivalent spherical lens(comparison of equivalent spherical lens between short group and normal group:p=0.945 for right eye,p=0.980 for left eye),radius of corneal curvature(comparison of corneal curvature between short group and normal group:p=0.602 for right eye,p=0.486 for left eye),axial ratio(comparison of axial ratio between short group and normal group:p=0.056 for right eye,p=0.432 for left eye),etc.2.After treatment with recombinant human growth hormone,the growth rate of height and eye axis of children with dwarfism increased significantly,It was higher than that of the normal control group and the conservative treatment group(the average growth rate of height:0.98cm/month in the rhGH treatment group for dwarfism,0.55cm/month in the normal control group,0.38cm/month in the conservative treatment group for dwarfism.The average growth rate of ocular axis:0.039±0.01 0mm/month in the rhGH treatment group for dwarfism,0.019±0.013mm/month in the normal control group,0.011±0.008mm/month in the conservative treatment group for dwarfism,X2=111.619,P=0.000).3.After rhGH treatment,the serum IGF-Ⅰ concentration in children with dwarfism increased significantly within one year(X2=71.709,t=0.000).At 18 months of treatment,the serum IGF-Ⅰ concentration was moderately positively correlated with the ocular axis(right eye:r=0.668,p=0.000,left eye:r=0.658,p=0.000).At 12 months of treatment,the serum IGF-Ⅰconcentration was slightly or moderately negatively correlated with the equivalent spherical lens(right eye:r=0.454,p=0.012,left eye:r=0.377,p=0.040).At 18 months of treatment,the serum IGF-Ⅰ concentration was highly negatively correlated with the equivalent spherical lens(right eye:r=0.853,p=0.000,left eye:r=0.835,p=0.000).4.In the 30 patients in the rhGH treatment group for dwarfism,4 patients were diagnosed with myopia at 6 months,with a myopia rate of 13.33%;6 patients were diagnosed with myopia at 12 months,with a myopia rate of 20%;13 patients were diagnosed with myopia at 18 months,with a myopia rate of 43.33%(X2=7.826,p=0.020).Among the 20 patients in the conservative treatment group of dwarfism,3 were finally diagnosed as myopia,with a myopia rate of 15%.The difference between the two groups was statistically significant(X2=4.427,p=0.035).5.Among the 13 myopic children in the rhGH treatment group for dwarfism,10 of them had a positive height curve at the intersection of their own genetic height curve when myopia began to appear,2 had a height curve that exceeded their own genetic height curve when myopia began to appear,and 1 had a height curve that did not reach their own genetic height curve when myopia began to appear.Conclusion 1.The height and ocular axis of children with dwarfism can be significantly increased after rhGH treatment,and the equivalent spherical lens gradually decreases with the passage of treatment time.2.After rhGH treatment,the serum IGF-Ⅰ concentration in children with short stature was moderately positively correlated with the ocular axis and highly negatively correlated with the equivalent spherical lens.3.The equivalent spherical mirror of children with dwarfism was changed from positive to negative at the 6th to 12th month after rhGH treatment.Early myopia was easy to occur at the 12th to 18th month,and the height growth curve and genetic height curve began to cross when myopia occurred.