| BackgroundIdiopathic short stature(ISS)is a common disease in pediatric endocrine clinics.It is the most common cause of short stature,accounting for 60%-80%.The specific pathogenesis is still unclear.At present,recombinant human growth hormone(rhGH)is still the only effective intervention method for ISS.In recent years,a large number of studies have shown that short-term intervention of rhGH can increase the growth rate of children,and long-term intervention is expected to increase the height of adulthood.However,current research suggests that rhGH not only plays an important role in the growth of long bone parts,but also has a great growth-promoting effect on the growth site of cartilage ossification such as cartilage and cranial base,which causes different reactions in different regions of the craniofacial region.Recent studies have shown that rhGH intervention can promote the growth and development of craniofacial bone in children with ISS,and further improves the facial profile,whereas there is no such reports in our country.It is necessary to explore the influence of rhGH intervention on the growth and development of craniofacial in children with ISS in China,opening up a new perspective for the diagnosis and treatment of children with ISS.ObjectiveThis study was to explore the effect of rhGH intervention on craniofacial growth and development in children with ISS,and to provide new comprehensive evaluation information for the diagnosis and treatment of children with ISS.MethodAll total of 24 prepubertal ISS children diagnosed and treatment at least one year in the Children's Endocrinology Specialist Clinic of the Third Affiliated Hospital from September 2016 to May 2018,including 12 males and 12 females,with an average age of 10.34±1.68(7-12)years old.In the same period,22 prepubertal healthy children with the same age,gender,facial shape,and facial features were basically coordinated,facial shape had no obvious protrusion and retraction,no history of trauma,and no orthodontic treatment and orthognathic treatment were performed,including 12 males and 10 females,with an average age of 10.54±1.74(7-12)years,were followed up for one year.Children with ISS group and control group were scanned via Volmetric CT,before the rhGH intervention and one year after the intervention(or follow-up).The three-dimmensional reconstructed image and measurement were performed in Workstation.Three-dimensional measurement of various linear and angular indicators of images,and observation of changes in various indicators.Result1.Before rhGH treatment,girls and boys with ISS cases showed a skeletal Class II facial profile compared with controls(t=12.39,10.442,p<0.05).2.After one year of rhGH treatment,lower anterior facial height and anterior facial height increased more in girls with ISS than in controls(t=3.412,5.215,p<0.05),the linear indexs of the remaining craniofacial bones measurements had no significant difference in controls(t=-1.803,1.413,-1.990,-1.645,-0.388,1.204,1.932,p>0.05).3.Lower anterior facial height increased more in boys with ISS than incontrols(t= 2.372,p < 0.05),the linear indexs of the remaining craniofacial bones measurements had no significant difference in controls(t=-0.918,-1.872,0.584,-1.480,-0.530,1.164,0.275,-1.209,p>0.05).4.The length of the anterior cranial base and posterior cranial base and the growth of the maxilla were negatively correlated with age(r=-0.486,-0.761,-0.612,p<0.05).5.Therapy of rhGH have no infiuence on thyroid function,liver and kidney function and blood glucose.Conclusion1.Before rhGH treatment,with ISS causes reduction of all linear measuerments of craniofacial growth(except for the upper and lower front of the ISS boy group),particulary the mandibular ramus height.2.The short-term treatment of rhGH can promote the growth of craniofacial skeleton in idiopathic short stature,which can slightly improve the facial contour of children,but no signs of asymmetric growth. |
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