Objective To study the relationship between insulin-like growth factor-1 (IGF-1) and body mass index (BMI) in children with growth hormone deficiency (GHD). Methods The clinical data of 137 children with GHD were retrospectively analyzed.The data of body height (Ht),body weight (Wt),BMI,serum growth hormone (GH) and serum IGF-1 were collected. Results 1) The level of IGF-1 in children with GHD was positively correlated with BMI;2) The level of IGF-1 in children with GHD was influenced by factors such as sex,BMI,adolescent status and other factors;3) In the group of BMI SDS<0.30,IGF-1 SDS decreased significantly by 2% for per 1 unit increase of BMI SDS (P>0.05).In the BMI SDS≥0.30 group,IGF-1 SDS increased significantly by 93% for every 1 unit increase of BMI SDS (P<0.001);4) After adjusted for gender,platelet,aspartate aminotransferase,creatinine,high density lipoprotein,luteinizing hormone,follicle stimulating hormone,estradiol,testosterone,the level of IGF-1 SDS increased by 39.3% for per unit increase of BMI SDS in prepuberty children with GHD and decreased by 98.8% for per unit increase of BMI SDS in puberty children with GHD (P<0.001 or <0.05). Conclusions The level of IGF-1 in children with GHD is affected by factors such as sex,BMI,and adolescent status.Appropriate level of BMI can promote the growth and development of GHD children.GHD children should increase BMI appropriately at prepuberal stage,and control BMI at puberty,which may help maintain a high level of IGF-1 and facilitate its growth and development.
Key words
growth hormone deficiency /
body mass index /
IGF-1
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Wang Q,Liu DY,Yang LQ,et al.The epidemic characteristics of short stature in school students[J].Ital J Pediatr,2015,41(99):2-6.
[2] 班博,潘慧,邵倩,等.山东济宁地区270例矮小症病因及诊断线索分析[J].中华诊断学电子杂志,2014,2(2):100-104.
[3] 中华医学会儿科学分会内分泌遗传代谢学组.矮身材儿童诊治指南[J].中华儿科杂志,2008,46(6):428-430.
[4] 李辉,季成叶,宗心南,等.中国0-18岁儿童,青少年体质量指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[5] Cole TJ,Flegal KM,Nicholls D,et al.Body mass index cut offs to define thinness in children and adolescents:International survey[J].BMJ,2007,335(7612):194.
[6] Tsuyoshi I,Akira S,Susumu Y,et al.Standardized centile curves and reference intervals of serum insulin-like growth factor-I (IGF-I) levels in a normal Japanese population using the LMS method[J].Endocr J,2012,59(9):771-780.
[7] 陈龙,陈晓青.特发性矮身材儿童生长障碍与GH-IGF1轴关系的研究进展[J].临床合理用药杂志,2016,9(10):179-181.
[8] Lundberg E,Kristrom B,Jonsson B,et al.Growth hormone(GH)dose-department IGF-1 response relates to pubertal height gain[J].BMC Endocr Disord,2015,15(1):84.
[9] 徐源.中国正常成人血清IGF-1的参考范围及其影响因素研究[D].北京:北京协和医学院,2016.
[10] Hok,Glbney J,Johannssong,et al.Regulating of growth hormone sensitivity by sex steroids:implications for therapy[J].Pituitary Today:Molecular,Physiological and Clinical Aspects,Basel:Karger Publishers,2006,35:115-128.
[11] 许珊珊,顾学范,潘慧,等.儿童青少年血清胰岛素生长因子-1及胰岛素因子结合蛋白-3的正常参考值研究[J].临床儿科杂志,2009,27(17):1105-1110.
[12] Hindmarsh PC,Dennison E,Pincus SM,et al.A sexually dimorphic pattern of growth hormone secretion in the elderly[J].J Cli Endocrinol Metab,2011,84(8):2679-2685.
[13] Savastano S,Di Somma C,Barrea L,et al.The complex relationship between obesity and the somatropic axis:the long and winding road[J].Growth Horm IGF Res,2014,24(6):221-226.
[14] Friedrich N,Thuesen B,JØrgensen T,et al.The association between IGF-I and insulin resistance a general population study in Danish adults[J].Diabetes Care,2012,35(4):768-773.
[15] Aguirre GA,De Ita JR,de la Garza RG,et al.Insulin-like growth factor-1 deficiency and metabolic syndrome[J].J Transl Med,2016,14(1):1-3
[16] Cianfarani S,Inzaghi E,Alisi,A et al.Insulin-like growth factor-I and -II levels are associated with the progression of nonalcoholic fatty liver disease in obese children[J].J Pediatr,2014,165(1):92-98.
[17] Kadakia R,Ma M,Josefson JL.Neonatal adiposity increases with rising cord blood IGF-1 levels[J].Clin Endocrinol(Oxf),2016,85(1):70-75.
[18] Liang SH,Hu YY,Liu CH.Low insulin-like growth factor 1 is associated with low high-density lipoprotein cholesterol and metabolic syndrome in Chinese nondiabetic obese children and adolescents:a cross-sectional study[J].Lipids in Health and Disease,2016,15(112):2-7.
[19] 肖满田,萧灿荣,丘小汕,等.功能性消化不良儿童IGF-1水平变化与营养指标关系研究[J].中国儿童保健杂志,2017,25(4):392-394.
[20] 吴央,刘燕玲.特发性矮小患儿血清IGF-1、IGFBP-3水平、骨龄改变与体格发育的相关性[D].南昌:南昌大学,2015.
PDF(597 KB)
