Effects Of RhGH Treatment On Lipid Metabolism In GHD Children And Evaluation Of Its Efficacy

Objective:In this study,children with growth hormone deficiency were taken as the research object,and blood lipid was used as the research index to observe the changes in blood lipid level of GHD children before and after the application of recombinant human growth hormone therapy,and to explore the influence of rh GH treatment on the lipid metabolism of GHD children.Taking height,growth rate and height standard deviation score as evaluation indexes,evaluate the therapeutic effect of rh GH in GHD children.Methods:From October 2016 to October 2018,50 cases of children admitted to our hospital and diagnosed with GHD were set as the treatment group.At the same time,30 healthy normal height children without organic diseases were selected as the control group.Rh GH was given to the treatment group,while no treatment was given to the control group.All enrolled children were given reasonable diet,exercise and sleep guidance.A one-year followed-up study was made to monitor the children in the treatment group.Total cholesterol,triglyceride,LDL cholesterol,HDL cholesterol,apolipoprotein A1,apolipoprotein B,and apolipoprotein A1/B were collected from the control group.The growth rate of the treatment group before treatment was collected.Collect the treatment group before and after treatment of gender,age,height,weight,Tanner stage,total cholesterol,triglyceride,low density lipoprotein cholesterol,high-density lipoprotein cholesterol and apolipoprotein A1,apolipoprotein B and apolipoprotein A1 / B,insulin-like growth factor 1,such as data,calculate standard deviation score for height,body mass index and the growth rate of 1 year after treatment.SPSS22.0 statistical software was used for data analysis.Measurement data were expressed by mean plus or minus standard deviation,and classified counting data were expressed by frequency or rate.T test was used when the two groups of measurement data were subject to normal distribution,while Wilcoxon symbolic rank sum test was used when the data were not subject to normal distribution.Paired T test was used for comparison of measurement data before and after treatment,and paired rank test was used for comparison of measurement data before and after treatment.The chi-square test was used to compare the counting data.P < 0.05 was considered statistically significant.Results :1.Dyslipidemia before treatment in the treatment group: among the 50 children in the treatment group,23 children(46%)had dyslipidemia,including 12 children with abnormal TG,8 children with abnormal TC,6 children with abnormal HDL-C and 10 children with abnormal LDL-C.2.Comparison of blood lipid before treatment between the control group and the treatment group: TG,TC and LDL-C levels of the children in the treatment group were all higher than those in the control group before treatment,and the difference was statistically significant(P=0.043;P < 0.001;P< 0.001);Apo B was higher than the control group,and the difference was not statistically significant(0.87 0.08 VS 0.85 0.08,P = 0.364);HDL-C was lower than the control group,and the difference was statistically significant(P<0.001).Apoa-1 was lower than the control group,and the difference was statistically significant(1.28 0.08 VS 1.38 0.09,P<0.001).Apoa-1 / B was lower than the control group,and the difference was statistically significant(1.48 0.14 VS 1.63 0.20,P=0.001).3.Comparison of blood lipid before and after treatment in the treatment group: TG,TC and LDL-C levels after treatment were lower the figure before treatment,and the difference was statistically significant(P<0.001;P < 0.001;P < 0.001);Apo B was lower than th figure before treatment,and the difference was not statistically significant(0.84 0.12 VS 0.87 0.08,P=0.122).HDL-C was higher than the figure before treatment,and the difference was statistically significant(P=0.001).Apoa-1 was higher than the figure before treatment,and the difference was statistically significant(1.46 0.09 VS 1.28 0.08,P<0.001).Apoa-1 / B was higher than the figure before treatment,and the difference was statistically significant(1.77 0.30 VS 1.48 0.14,P<0.001).4.Efficacy of rh GH in the treatment group: after 1 year of treatment,Ht,Ht SDS and GV of GHD children were significantly increased compared with the figure before treatment,and the difference was statistically significant(P <0.001).There was no statistically significant difference in BMI between before and after treatment(P=0.080).IGF-1 level was significantly higher than the figure before treatment,and the difference was statistically significant(P <0.001).5.During the follow-up of GHD children in this study,there were no abnormalities in blood,urine routine,liver and kidney functions,blood glucose and thyroid functions.No side effects such as allergy,vision loss and headache occurred.Conclusion:1.Children with GHD have abnormal lipid metabolism to different degrees,which is significantly improved after rh GH treatment.2.After rh GH treatment,the growth rate of GHD children can be significantly increased,and the effect of growth promotion is obvious.