UNASSIGNED: Literature retrieval, study selection, and data extraction were completed independently and in duplicate. Effect-size estimates are expressed as standardized mortality ratios (SMRs), standardized incidence ratio (SIR), and relative risk (RR) with a 95% CI.
UNASSIGNED: Data from 24 articles, involving 254,776 persons, were meta-analyzed. Overall analyses revealed the association of rhGH therapy was not statistically significant with all-cause mortality (SMR = 1.28; 95% CI: 0.58-2.84; P = 0.547; I 2 = 99.2%; Tau2 = 2.154) and cancer mortality (SMR = 2.59; 95% CI: 0.55-12.09; P = 0.228; I 2 = 96.7%; Tau2 = 2.361) and also cancer incidence (SIR = 1.54; 95% CI: 0.68-3.47; P = 0.229; I 2 = 97.5%; Tau2 = 2.287), yet statistical significance was observed for second neoplasm (RR = 1.77; 95% CI: 1.33-2.35; P = 0.001; I 2 = 26.7%; Tau2 = 0.055). Differences in the geographic region, gender, treatment duration, mean rhGH dose, overall rhGH exposure dose, and initial disease accounted for heterogeneity in the subgroup analyses.
UNASSIGNED: Our findings indicate that the rhGH therapy is not related to all-cause mortality and cancer mortality and cancer incidence, yet it seems to trigger a second tumor risk. Future prospective studies are needed to confirm our findings and answer the more challenging question regarding the optimal dose of rhGH therapy in children and adolescents.
未经批准:文献检索,研究选择,和数据提取独立完成,一式两份。效应大小估计值表示为标准化死亡率比率(SMR),标准化发病率(SIR),和相对风险(RR),CI为95%。
未经评估:来自24篇文章的数据,涉及254,776人,进行了荟萃分析。总体分析显示,rhGH治疗与全因死亡率无统计学意义(SMR=1.28;95%CI:0.58-2.84;P=0.547;I2=99.2%;Tau2=2.154)和癌症死亡率(SMR=2.59;95%CI:0.55-12.09;P=0.228;I2=96.7;Tau2=2.361)以及癌症发病率(SIR=0.47-然而,对于第二次肿瘤,观察到统计学意义(RR=1.77;95%CI:1.33-2.35;P=0.001;I2=26.7%;Tau2=0.055).地理区域的差异,性别,治疗持续时间,平均rhGH剂量,rhGH总暴露剂量,和初始疾病在亚组分析中占异质性。
未经评估:我们的研究结果表明,rhGH治疗与全因死亡率、癌症死亡率和癌症发病率无关。但它似乎会引发第二次肿瘤风险。需要未来的前瞻性研究来证实我们的发现,并回答关于儿童和青少年rhGH治疗最佳剂量的更具挑战性的问题。