Abstract：
BACKGROUND: There is no appropriate tool to predict recombinant human growth hormone (rhGH) response before therapy initiation in short-stature children in late puberty. The current study aimed to explore the associations between magnetic resonance imaging (MRI) stages of the knee growth plates and rhGH response in short-stature children in late puberty.
METHODS: In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later.
RESULTS: Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV1-3 mon from 9.38 to 6.08 to 4.56 cm/year, GV4-6 mon from 6.75 to 4.92 to 3.25 cm/year, and height gain from 4.03 to 2.75 to 1.95 cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01).
CONCLUSIONS: The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty.
METHODS: In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later.
RESULTS: Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV1-3 mon from 9.38 to 6.08 to 4.56 cm/year, GV4-6 mon from 6.75 to 4.92 to 3.25 cm/year, and height gain from 4.03 to 2.75 to 1.95 cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01).
CONCLUSIONS: The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty.
摘要：
背景：没有合适的工具来预测青春期晚期身材矮小的儿童在治疗开始前的重组人生长激素（rhGH）反应。本研究旨在探讨青春期晚期身材矮小儿童膝关节生长板的磁共振成像（MRI）阶段与rhGH反应之间的关系。
方法：在这项前瞻性队列研究中，青春期晚期身材矮小儿童接受rhGH治疗，随访6个月。我们根据股骨远端或胫骨近端的生长板状态提出了一种新型的膝关节MRI分期系统，并将参与者分为三组：未闭合的生长板组，边缘封闭的生长板组，和接近封闭的生长板组。主要结果是身高增长和生长速度（GV），三个月后进行了评估。
结果：招募了50名参与者，包括23个男孩和27个女孩。rhGH治疗6个月后，随着生长板融合程度的增加，三组GV和身高增加依次下降，特别是按胫骨近端分组时(GV1-3mon从9.38到6.08到4.56厘米/年，GV4-6从6.75到4.92到3.25厘米/年，高度从4.03到2.75到1.95厘米，所有P<0.001)。此外，生长板的MRI分期独立地作为治疗后GV和身高增加的重要变量，尤其是按胫骨近端分组时（均P<0.01）。
结论：MRI分期方法有望成为预测青春期后期矮小儿童开始治疗前rhGH反应的有效工具。
方法：在这项前瞻性队列研究中，青春期晚期身材矮小儿童接受rhGH治疗，随访6个月。我们根据股骨远端或胫骨近端的生长板状态提出了一种新型的膝关节MRI分期系统，并将参与者分为三组：未闭合的生长板组，边缘封闭的生长板组，和接近封闭的生长板组。主要结果是身高增长和生长速度（GV），三个月后进行了评估。
结果：招募了50名参与者，包括23个男孩和27个女孩。rhGH治疗6个月后，随着生长板融合程度的增加，三组GV和身高增加依次下降，特别是按胫骨近端分组时(GV1-3mon从9.38到6.08到4.56厘米/年，GV4-6从6.75到4.92到3.25厘米/年，高度从4.03到2.75到1.95厘米，所有P<0.001)。此外，生长板的MRI分期独立地作为治疗后GV和身高增加的重要变量，尤其是按胫骨近端分组时（均P<0.01）。
结论：MRI分期方法有望成为预测青春期后期矮小儿童开始治疗前rhGH反应的有效工具。
