关键词: 矮小症, 生长激素释放激素, 生长激素缺乏症, 左旋多巴生长激素激发试验, 胰岛素低血糖生长激素激发试验, 血脂异常, 儿童, 青少年

Abstract: Background　Short stature is a common problem in children's growth and development，which is caused mainly by growth hormone deficiency （GHD），and its diagnosis depends on the growth hormone（GH） stimulation test.Studies have shown that serum lipid levels may be one of the factors that influence the variability of GH response at a stimulation test.However，similar studies have not been conducted in child population yet.Objective　To investigate the relationship between serum lipids and peak GH at a stimulation test in children and adolescents with short stature，to provide evidence for possible factors influencing the stimulated peak GH in such populations.Methods　A retrospective analysis was performed on 1 009 Chinese children and adolescents with short stature recruited from Department of Endocrinology，Jining Medical University，from 2013 to 2017.Clinical data such as height，body weight，and other anthropometric parameters as well as serum lipid profile，results of GH stimulation test with L-dopa or insulin-induced hypoglycemia test （insulin tolerance test，ITT） were collected.Stratified analysis was performed on two subgroups 〔dwarfism subgroup （n=595） and slightly undersized subgroup （n=414）〕 divided by the third height percentile.Univariate and multiple linear regression analyses were used to explore the correlations of peak GH at a stimulation test with anthropometric parameters and serum lipids.Results　The peak GH value at the stimulation test with L-dopa （PEAK1） was negatively correlated with body weight，BMI，BMI SDS，TG，TC，HDL-C，LDL-C，VLDL-C，and ALT，but positively correlated with IGF-1 （P<0.05）；the peak GH value at the ITT （PEAK2） was negatively correlated with BMI SDS，TC，and HDL-C，but positively correlated with female，age，bone age，height，body weight，Hb and IGF-1 （P<0.05）．Multiple linear regression analysis showed that PEAK1 was negatively correlated with both TG and HDL-C （P<0.05），and PEAK2 was negatively correlated with HDL-C （P<0.05）．In the dwarfism subgroup，PEAK1 showed a negative correlation with HDL-C （P<0.05）．In the slightly undersized subgroup，PEAK1 demonstrated a negative correlation with both TG and HDL-C （P<0.05），and PEAK2 demonstrated a negative correlation with HDL-C （P<0.05）．Conclusion　This study suggests that serum lipids affect the response of GH at the stimulation test.It is suggested that low-fat diet should be adopted before the GH stimulation test，which may improve the accuracy of diagnosis of GHD.

Key words: Short stature, Growth hormone-releasing hormone, Growth hormone deficiency, Growth hormone stimulation test with L-dopa, Insulin-induced hypoglycemia test, Dyslipidemias, Child, Adolescent