DOI QR코드

DOI QR Code

Growth Outcome and Metabolic Profile of PWS Patients Treated with GH and Differences between AGA and SGA Group

  • Yoon, Ju Young (Department of Pediatrics, Pusan National University Children's Hospital)
  • 투고 : 2022.09.27
  • 심사 : 2022.10.11
  • 발행 : 2022.10.31

초록

Background: Prader-Willi syndrome (PWS) is a complex genetic disease associated with growth impairment, severe obesity and metabolic dysfunctions. High proportion of PWS patients are born small for gestational age (SGA) than normal children, which also increase the risk of growth impairment and metabolic dysfunction in PWS. We aimed to compare growth outcome and metabolic profiles between SGA and appropriate for gestational age (AGA) PWS patients. Methods: Data of 55 PWS children and adults aged more than 2 years old (32 male and 23 female, age 2-18.8 years) from single center were studied. Only patients who were treated with GH were included. The clinical characteristics and laboratory findings were reviewed retrospectively. Results: Among 55 subjects, 39 had 15q11-13 deletion and 16 had uniparental disomy (UPD). Twenty (36.3%) were born SGA. All patients received GH treatment, and 11 (20%) discontinued GH treatment. Mean age at GH treatment initiation was 2.5 (range 0.3-12.4) years, and mean duration of treatment was 6.3 (range 1.0-11.3) years. Current height-SDS (-0.36 vs -0.16) and BMI-SDS (1.44 vs 1.33) did not differ between AGA and SGA group. Two patients in SGA group, but none in AGA group had diabetes mellitus. Mean glucose level was also higher in SGA group (100.1 vs 114.4 mg/dL). Conclusion: Our report gives an overview of growth profile and metabolic dysfunctions recorded in GH treated PWS patients. Growth profile did not differ between AGA and SGA group. Glucose level was higher in SGA group, so more careful monitoring and prevention for DM will be required in SGA group.

키워드

참고문헌

  1. Butler MG, Brandau DT, Theodoro M, Garg U. Cortisol levels in Prader-Willi syndrome support changes in routine care. Am J Med Genet A 2009;149A(2):138-9. https://doi.org/10.1002/ajmg.a.32633
  2. Goldstone AP, Holland AJ, Hauffa BP, Hokken-Koelega AC, Tauber M. Recommendations for the diagnosis and management of Prader-Willi syndrome. J Clin Endocrinol Metab 2008;93(11):4183-97. https://doi.org/10.1210/jc.2008-0649
  3. de Lind van Wijngaarden RF, Siemensma EP, Festen DA, Otten BJ, van Mil EG, Rotteveel J, et al. Efficacy and safety of long-term continuous growth hormone treatment in children with Prader-Willi syndrome. J Clin Endocrinol Metab 2009;94(11):4205-15. https://doi.org/10.1210/jc.2009-0454
  4. Burman P, Ritzen EM, Lindgren AC. Endocrine dysfunction in Prader-Willi syndrome: A review with special reference to GH. Endocr Rev 2001;22(6):787-99. https://doi.org/10.1210/edrv.22.6.0447
  5. Angulo MA, Castro-Magana M, Lamerson M, Arguello R, Accacha S, Khan A. Final adult height in children with Prader-Willi syndrome with and without human growth hormone treatment. Am J Med Genet A 2007;143A(13):1456-61. https://doi.org/10.1002/ajmg.a.31824
  6. Cassidy SB, Schwartz S, Miller JL, Driscoll DJ. Prader-Willi syndrome. Genet Med 2012;14(1):10-26. https://doi.org/10.1038/gim.0b013e31822bead0
  7. Eiholzer U, l'Allemand D. Growth hormone normalises height, prediction of final height and hand length in children with Prader-Willi syndrome after 4 years of therapy. Horm Res 2000;53(4):185-92.
  8. Angulo MA, Butler MG, Cataletto ME. Prader-Willi syndrome: a review of clinical, genetic, and endocrine findings. J Endocrinol Invest 2015;38(12):1249-63. https://doi.org/10.1007/s40618-015-0312-9
  9. Miller JL, Lynn CH, Driscoll DC, Goldstone AP, Gold JA, Kimonis V, et al. Nutritional phases in Prader-Willi syndrome. Am J Med Genet A 2011;155A(5):1040-9.
  10. Albertsson-Wikland K, Karlberg J. Postnatal growth of children born small for gestational age. Acta Paediatr Suppl 1997;423:193-5. https://doi.org/10.1111/j.1651-2227.1997.tb18413.x
  11. Leger J, Limoni C Fau - Czernichow P, Czernichow P. Prediction of the outcome of growth at 2 years of age in neonates with intra-uterine growth retardation. Early Hum Dev 1997;48(3):211-23. https://doi.org/10.1016/S0378-3782(96)01855-5
  12. Rapaport R. Growth and growth hormone in children born small for gestational age. Growth Horm IGF Res 2004;14 Suppl A:S3-6. https://doi.org/10.1016/j.ghir.2004.03.003
  13. Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr 2018;61(5):135-49. https://doi.org/10.3345/kjp.2018.61.5.135
  14. Meazza C, Pagani S, Pietra B, Tinelli C, Calcaterra V, Bozzola E, et al. Different Long-Term Response to Growth Hormone Therapy in Small- versus Appropriate-for-Gestational-Age Children with Growth Hormone Deficiency. Horm Res in Paediatr 2013;79(4):214-9. https://doi.org/10.1159/000350239
  15. Jung H, Rosilio M, Blum WF, Drop SL. Growth hormone treatment for short stature in children born small for gestational age. Adv Ther 2008;25(10):951-78. https://doi.org/10.1007/s12325-008-0101-3