Hormone research · 2008
Metabolic control and growth during exclusive growth hormone treatment in X-linked hypophosphatemic rickets.
Клиническое исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Makitie Outi, Toiviainen-Salo Sanna, Marttinen Eino, Kaitila Ilkka, Sochett Etienne, Sipila Ilkka
Аннотация
BACKGROUND: GH may improve phosphate balance and height in X-linked hypophosphatemic rickets (XLH). This study evaluated the impact of exclusive rhGH therapy on phosphate homeostasis and growth.
METHODS: Ten children (median age 12.2 years) with XLH were included in a 12-month trial with GH. Conventional treatment was discontinued 1 month prior GH (0.033 mg/kg/day); 1alpha-hydroxyvitamin D was added at 6 months and oral phosphate at 12 months, when GH was discontinued. Patients were followed 1-3 monthly until 18 months for clinical, biochemical and radiographic parameters.
RESULTS: Serum phosphate Z-score increased significantly from baseline at 6 months (p = 0.005) and 9 months (p = 0.009) but returned to baseline by 12 months. Serum 1,25-dihydroxyvitamin D also increased significantly. Parathyroid function normalized. The median height Z-score was -2.2 (-2.7 to +0.4) at GH onset and -1.7 (-2.3 to +0.3) at 12 months. One patient showed a significant increase in radiographic rickets activity and 3 patients aggravation of lower limb deformity; the others showed no changes or improvement in these parameters.
CONCLUSIONS: GH treatment improved serum phosphate and 1,25-dihydroxyvitamin D, normalized parathyroid function and improved longitudinal growth in XLH. It may however aggravate pre-existing skeletal deformities.
METHODS: Ten children (median age 12.2 years) with XLH were included in a 12-month trial with GH. Conventional treatment was discontinued 1 month prior GH (0.033 mg/kg/day); 1alpha-hydroxyvitamin D was added at 6 months and oral phosphate at 12 months, when GH was discontinued. Patients were followed 1-3 monthly until 18 months for clinical, biochemical and radiographic parameters.
RESULTS: Serum phosphate Z-score increased significantly from baseline at 6 months (p = 0.005) and 9 months (p = 0.009) but returned to baseline by 12 months. Serum 1,25-dihydroxyvitamin D also increased significantly. Parathyroid function normalized. The median height Z-score was -2.2 (-2.7 to +0.4) at GH onset and -1.7 (-2.3 to +0.3) at 12 months. One patient showed a significant increase in radiographic rickets activity and 3 patients aggravation of lower limb deformity; the others showed no changes or improvement in these parameters.
CONCLUSIONS: GH treatment improved serum phosphate and 1,25-dihydroxyvitamin D, normalized parathyroid function and improved longitudinal growth in XLH. It may however aggravate pre-existing skeletal deformities.
Предметные рубрики MeSH
AdolescentBody HeightBone Density Conservation AgentsBone DevelopmentBone and BonesChildChild, PreschoolDose-Response Relationship, DrugDrug Therapy, CombinationFamilial Hypophosphatemic RicketsFemaleGenetic Diseases, X-LinkedGrowth HormoneHomeostasisHumansHydroxycholecalciferolsHyperparathyroidismMaleParathyroid GlandsPhosphatesRadiographyVitamin D