Efficacy And Safety Of Recombinant Human Growth Hormone In The Treatment Of Growth Hormone Deficiency And Idiopathic Short Stature

Objective: Children with idiopathic short stature(ISS)and growth hormone deficiency(GHD)who had received recombinant human growth hormone(rhGH)treatment for more than 2 years and were regularly followed up in our hospital were selected.The changes in clinical monitoring indicators before and during treatment were retrospectively analyzed to evaluate the efficacy and safety of rhGH treatment for ISS and GHD.Methods: Among the children who met the diagnostic criteria of ISS and GHD in our hospital from November 2015 to November 2019,115 children who received rhGH treatment for more than 2 years and could regularly visit our hospital for follow-up were selected.There were 54 patients in the ISS group and 61 in the GHD group.Clinical monitoring indicators of these children during regular follow-up in our hospital were collected.The clinical monitoring indicators of these children during regular follow-up in our hospital were collected.The height of the pituitary gland at the time of initial treatment,height,annual growth rate(GV),fasting blood glucose,free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),insulin-like growth factor(IGF-1),and insulin Growth factor-like binding protein(IGFBP-3).before treatment,3 months after treatment,6 months after treatment,1 year after treatment,and 2 years after treatment were collected.These clinical monitoring indicators were statistically analyzed.Results:1.After 2 years of treatment,the height,GV,IGF-1 and IGFBP-3 levels of ISS group and GHD group were significantly higher than those before treatment(P < 0.05);2.After 2 years of treatment,the fasting blood glucose levels of ISS group and GHD group were significantly higher than those before treatment(P < 0.05).However,the fasting blood glucose level after 6 months of treatment was not significantly different from that at 3 months of treatment(P > 0.05).The fasting blood glucose levels were almost all within the normal range during the treatment.3.After 2 years of treatment,the levels of FT3 and TSH in GHD group were not significantly different from those before treatment(P > 0.05).However,after 6 months of treatment,the FT3 level of the GHD group was higher than that before treatment(P< 0.05),and after 3 months and 2 years of treatment,the FT4 level of the GHD group was lower than that before treatment(P < 0.05).After 2 years of treatment,the levels of FT3,FT4,and TSH in the ISS group had no significant differences compared with those before treatment(P > 0.05).The level of FT4 in the ISS group after 3 months of treatment was lower than that before treatment(P < 0.05).4.GV of children in ISS group and GHD group decreased gradually with the extension of rhGH treatment time,and there was no significant difference in GV between the two groups in rhGH treatment of ISS group and GHD group(P > 0.05).5.No correlation was found between GV and pituitary height at initial treatment in children with ISS and GHD treated with rhGH..Conclusions: rhGH treatment can significantly improve the height,GV,IGF-1,and IGFBP-3 levels of children with GHD and ISS,with a significant effect.However,during treatment,it can cause an increase in fasting blood glucose level and thyroid function disorder.