Changes of serum growth hormone-releasing peptide and insulin-like growth factor-1 in children with different disease causes of short stature and its clinical significance
Wang Kecheng, Tang Haijun, Shen Li
(Department of Pediatrics, Rugao Branch, Rugao Bo'ai Hospital, Affiliated Hospital of Nantong University, Jiangsu, Rugao 226500, China
Abstract: 【Abstract】 Objective To explore the changes of serum growth hormone-releasing peptide (Ghrelin) and insulin-like growth factor-1 (IGF-1) in children with different disease causes of short stature and its clinical significance. Method A total of 212 children with short stature admitted to Rugao Branch, Affiliated Hospital of Nantong University were enrolled between January 2016 and January 2022. According to different disease causes, they were divided into growth hormone deficiency group (n=60), idiopathicshort stature group (n=46), Turner syndrome group (n=38), congenital hypothyroidism group (n=32) andintrauterine growth retardation group (n=36). A total of 106 healthy children with matched height, gender andage during the same period in same hospital were enrolled as control group. The demographic characteristics,growth and development indexes [bone age difference (BAD), height standard deviation score (Ht SDS),annual growth velocity (GV), growth hormone (GH)], levels of serum Ghrelin and IGF-1 before and duringadolescence were compared between children with different disease causes of short stature and control group.The differential diagnosis value of serum Ghrelin and IGF-1 levels in idiopathic short stature was analyzedby receiver operating characteristic (ROC) curve. Statistical methods performed by One-way analysis of variance, LSD-t test, and χ2 test. Result The proportion of adolescent children in the idiopathic shortstature group was 65.2%, which was significantly higher than that in the other 4 groups (all P<0.05). Theproportion of adolescent children from high to low was intrauterine growth retardation group (41.7%),congenital hypothyroidism group (40.6%), growth hormone deficiency group (35.0%) and Turner syndromegroup (31.6%). The BAD of the idiopathic short stature group was (1.4±0.3) years, which was significantlyhigher than that of the other 4 groups (all P<0.05). The BAD values from high to low were (1.2±0.2) yearsin growth hormone deficiency group, (1.1±0.2) years in congenital hypothyroidism group, (0.7±0.1) yearsin Turner syndrome group and (0.3±0.1) years in intrauterine growth retardation group. The GV of theidiopathic short stature group was (3.7±0.8) cm/year, which was significantly higher than that of the other 4groups (all P<0.05). The GV from high to low were (2.2±0.7) cm/year in growth hormone deficiency group,(2.1±0.6) cm/year in intrauterine growth delay group, (1.7±0.5) cm/year incongenital hypothyroidism group,and (1.2±0.4) cm/year in Turner syndrome group. The peak GH value of the growth hormone deficiencygroup was (6.4±0.3) μg/L, which was significantly lower than that of the other 4 groups (all P<0.05). Thepeak GH values from low to high were (13.4±3.2) μg/L in intrauterine growth retardation group, (14.2±2.1)μg/L in Turner syndrome group, (14.7±2.5) μg/L in idiopathic short stature group, and (15.6±2.9) μg/L incongenital hypothyroidism group. Ghrelin level in the Turner syndrome group was significantly higher thanthat in growth hormone deficiency group, idiopathic short stature group, congenital hypothyroidism group andintrauterine growth retardation group (all P<0.05). The level of IGF-1 in congenital hypothyroidism groupwas significantly lower than that in growth hormone deficiency group, idiopathic short stature group, Turnersyndrome group and intrauterine growth retardation group (P<0.05). The levels of serum Ghrelin and IGF-1 in the prepubertal period of idiopathic short stature group were significantly lower than those in adolescence(P<0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of serum Ghrelinand IGF-1 for differential diagnosis of idiopathic short stature was 0.776 and 0.733, respectively. The AUC ofcombined detection for differential diagnosis of idiopathic short stature was 0.839, the sensitivity was 90.0%,and the specificity was 65.6% (P<0.001). Conclusion There are abnormal expressions of serum Ghrelinand IGF-1 in children with different disease causes of short stature. There are significant differences in levelsof serum Ghrelin and IGF-1 among idiopathic short stature children before and during adolescence. Thecombined detection of serum Ghrelin and IGF-1 has good efficiency in the differential diagnosis of idiopathicshort stature.
王克成 唐海俊 沈莉. 不同病因矮小症患儿血清生长激素释放肽、胰岛素样生长因子-1 水平变化及其临床意义[J]. 发育医学电子杂志, 2024, 12(3): 179-186.
Wang Kecheng, Tang Haijun, Shen Li . Changes of serum growth hormone-releasing peptide and insulin-like growth factor-1 in children with different disease causes of short stature and its clinical significance. Journal of Developmental Medicine(Electronic Version), 2024, 12(3): 179-186.
2024, Vol. 12 
