scholarly journals High Serum Levels of Growth Hormone (GH) and Insulin-Like Growth Factor-I (IGF-I) during High-Dose GH Treatment in Short Children Born Small for Gestational Age

2006 ◽  
Vol 91 (4) ◽  
pp. 1390-1396 ◽  
Author(s):  
Marije van Dijk ◽  
Paul Mulder ◽  
Mieke Houdijk ◽  
Jaap Mulder ◽  
Kees Noordam ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Serum Levels ◽  
High Serum ◽  
High Dose ◽  
Gh Treatment ◽  
Igf I ◽  
Group A ◽  
Group B ◽  
Igfbp 3

Context: Epidemiological studies have indicated that high serum levels of GH and IGF-I are associated with long-term risks. Objective: The objective of the study was to evaluate the changes in serum levels of GH during overnight profiles, IGF-I, and IGF binding protein 3 (IGFBP-3) in short small for gestational age (SGA) children during GH treatment with two doses. Patients: Thirty-six prepubertal short SGA children were the subjects of this study. Intervention: Subjects received 1 (group A) or 2 (group B) mg GH/m2·d. Main Outcome Measures: At baseline and after 6 months of GH treatment, overnight GH profiles were performed, and serum IGF-I and IGFBP-3 levels were measured. Results: After 6 months, group B had significantly higher GH levels during the profile (mean, maximum, and area under the curve above zero line) than group A (P < 0.009). In group B, maximum GH levels increased from 43.9–161 mU/liter (P < 0.0002), and in group A, from 57.2–104 mU/liter (P = 0.002). During the profile (i.e. 12 h per day), children of group B had mean GH levels of 64.4 vs. 34.8 mU/liter in group A (P = 0.001). The IGF-I and IGF-I to IGFBP-3 ratio sd scores increased significantly in both groups, but were higher in group B than A [1.5 vs. 0.2 (P = 0.002) and 1.4 vs. 0.3 (P = 0.007), respectively]. In group B, 74% of the children had IGF-I levels in the highest quintile during GH treatment compared with 19% in group A. Conclusion: Our study shows that high-dose GH treatment in short SGA children results in high serum GH and IGF-I levels in most children. We recommend monitoring IGF-I levels during GH therapy to ensure that these remain within the normal range.

scholarly journals Increases in Bioactive IGF do not Parallel Increases in Total IGF-I During Growth Hormone Treatment of Children Born SGA

2019 ◽  
Vol 105 (4) ◽  
pp. e1291-e1298 ◽  
Author(s):  
Mathilde Gersel Wegmann ◽  
Rikke Beck Jensen ◽  
Ajay Thankamony ◽  
Jan Frystyk ◽  
Edna Roche ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Receptor Activation ◽  
High Dose ◽  
Reference Ranges ◽  
Gh Treatment ◽  
Normal Reference ◽  
Igf I ◽  
One Year

Abstract Background Some children born small for gestational age (SGA) experience supra-physiological insulin-like growth factor-I (IGF-I) concentrations during GH treatment. However, measurements of total IGF-I concentrations may not reflect the bioactive fraction of IGF-I which reaches the IGF-I receptor at target organs. We examined endogenous IGF-bioactivity using an IGF-I kinase receptor activation (KIRA) assay that measures the ability of IGF-I to activate the IGF-IR in vitro. Aim To compare responses of bioactive IGF and total IGF-I concentrations in short GH treated SGA children in the North European Small for Gestational Age Study (NESGAS). Material and method In NESGAS, short SGA children (n = 101, 61 males) received GH at 67 µg/kg/day for 1 year. IGF-I concentrations were measured by Immulite immunoassay and bioactive IGF by in-house KIRA assay. Results Bioactive IGF increased with age in healthy pre-pubertal children (n = 94). SGA children had low-normal bioactive IGF levels at baseline (-0.12 (1.8 SD), increasing significantly after one year of high-dose GH treatment to 1.1 (1.4) SD, P < 0.01. Following high-dose GH, 68% (n = 65) of SGA children had a total IGF-I concentration >2SD (mean IGF-I 2.8 SDS), whereas only 15% (n = 15) had levels of bioactive IGF slightly above normal reference values. At baseline, bioactive IGF (SDS) was significantly correlated to height (SDS) (r = 0.29, P = 0.005), in contrast to IGF-I (SDS) (r = 0.17, P = 0.10). IGF-I (SDS) was inversely correlated to delta height (SDS) after one year of high-dose GH treatment (r = -0.22, P = 0.02). Conclusion In contrast to total IGF-I concentrations, bioactive IGF stayed within the normal reference ranges for most SGA children during the first year of GH treatment.

scholarly journals Metabolic implications of GH treatment in small for gestational age

2007 ◽  
Vol 157 (suppl_1) ◽  
pp. S47-S50 ◽  
Author(s):  
E M Delemarre ◽  
J Rotteveel ◽  
H A Delemarre-van de Waal
Keyword(s):  
Lipid Metabolism ◽  
Gestational Age ◽  
Growth Retardation ◽  
Small For Gestational Age ◽  
Postnatal Growth ◽  
Gh Treatment ◽  
Increased Risk ◽  
Igf I

Fetal growth retardation is associated with decreased postnatal growth, resulting in a lower adult height. In addition, a low birth weight is associated with an increased risk of developing diseases during adulthood, such as insulin resistance, type 2 diabetes mellitus, hypertension, dyslipidemia, and cardiovascular diseases. Children with persistent postnatal growth retardation, i.e., incomplete catchup growth, can be treated with human GH. The GH/IGF-I axis is involved in the regulation of carbohydrate and lipid metabolism. The question of whether treatment with GH in children born small for gestational age (SGA) has long-term implications with respect to glucose/insulin and lipid metabolism has not been answered yet. In this article, the available data are reviewed.

Application Value of Combined Detection of Serum IGF-I and IGFBP-3 in the Diagnosis of Bladder Cancer

2021 ◽  
Vol 7 (5) ◽  
pp. 3942-3947
Author(s):  
Xu-Dong Li ◽  
Sen Wei ◽  
Lei Wang
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Low Grade ◽  
Node Metastasis ◽  
Igf I ◽  
Group A ◽  
Muscle Invasive ◽  
Group B ◽  
Combined Detection ◽  
Igfbp 3

Objective. To investigate the application value of the combined detection of serum IGF-I and IGFBP-3 in the diagnosis of bladder cancer (BC). Methods.Sixty BC patients in our hospital (January 2019-January 2020) were chosen as group A, while sixty healthy people during the same period were chosen as group B. The serum IGF-I and IGFBP-3 levels of the subjects were detected to explore the relationship between the two levels (serum IGF-I and IGFBP-3) and BC.Results.Compared with group B, the two levelsof group A were lower while IGF-l/IGFBP-3 was higher. Compared with low-grade BC group, non-muscle invasive BC (NMIBC) group and non-lymph node metastasis group, the two levels were lower in high-grade BC group, muscle-invasive BC (MIBC) group and lymph node metastasis group (P<0.05). No notable difference in IGF-l/IGFBP-3 was found among patients with high-grade or low-grade BC, with or without lymph node metastasis, andwith or without muscular invasion (P>0.05). Conclusion. The serum IGF-I and IGFBP-3 levels of BC patients are obviously different compared with healthy people, and vary in patients with different types of BC, indicating the two factors can be applied in clinical diagnosic of BC.

Effect of sodium selenite on growth, insulin-like growth factor-binding proteins and insulin-like growth factor-I in rats

1995 ◽  
Vol 145 (1) ◽  
pp. 105-112 ◽  
Author(s):  
H Grønbæk ◽  
J Frystyk ◽  
H Ørskov ◽  
A Flyvbjerg
Keyword(s):  
Growth Factor ◽  
Sodium Selenite ◽  
Insulin Like Growth Factor ◽  
Factor I ◽  
Igf I ◽  
Selenium Treatment ◽  
Group A ◽  
Ad Libitum ◽  
Group B ◽  
Igfbp 3

Abstract Selenium is an essential trace element although at higher doses it is also known to be a toxic agent causing a wide range of symptoms including growth retardation. In order to investigate the effect of sodium selenite on growth, insulin-like growth factor-binding proteins (IGFBPs) and insulin-like growth factor-I (IGF-I), 30 male Wistar rats were randomized into three groups. Group A was treated with sodium selenite in the drinking water (3·3 mg selenium/l). Group B was ad libitum fed with free access to standard fodder and tap water and group C was pair fed relative to the selenium-treated rats. Serum IGF-I and IGFBPs were determined on days 0, 14 and at the end of the study on day 35. Selenium-treated rats had significantly lower body weights compared with group B rats on day 9 and group C rats on day 14 (P<0·05). Tibia length was measured at the end of the study and no difference was observed between groups B and C (3·77 ± 0·04 cm vs 3·60±0·02 cm); however, selenium-treated rats had significantly shorter tibia lengths (3·46±0·03 cm) compared with rats in groups B (P<0·001) and C (P<0·05). Selenium treatment induced a significant reduction in circulating IGF-I by the end of the study compared with ad libitum and pair fed rats (P<0·05). Serum subjected to Western ligand blots showed four distinct IGFBP bands with apparent relative molecular weights of 38–47 kDa (doublet) (IGFBP-3), 30 kDa (IGFBP-1 and/or IGFBP-2) and 24 kDa (IGFBP-4). At the end of the study a significant reduction in IGFBP-3 was observed in group A compared with groups B and C (P<0·05). Selenium treatment also caused a reduction in IGFBP-1 and/or IGFBP-2 compared with ad libitum fed rats; in addition, a reduction was observed in pair fed controls. In conclusion, sodium selenite treatment leads to growth retardation accompanied by reduced circulating levels of IGF-I, IGFBP-3, and IGFBP-1 and/or IGFBP-2. The reduction in IGF-I and IGFBP-3 could not be attributed to reduced caloric intake but seems to be a specific action of selenium. Journal of Endocrinology (1995) 145, 105–112

Growth hormone treatment during pregnancy in a growth hormone-deficient woman

1995 ◽  
Vol 132 (6) ◽  
pp. 727-729 ◽  
Author(s):  
Jørn Müller ◽  
Jørgen Starup ◽  
J Sandahl Christiansen ◽  
Jens OL Jøgensen ◽  
Anders Juul ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Treatment ◽  
Abdominal Ultrasound ◽  
Serum Levels ◽  
Hormone Treatment ◽  
Donor Insemination ◽  
Gh Treatment ◽  
Igf I ◽  
Igf Binding ◽  
Igfbp 3

Müller J, Starup J, Christiansen JS, Jørgensen JOL, Juul A, Skakkebaek NE, Growth hormone treatment during pregnancy in a growth hormone-deficient woman. Eur J Endocrinol 1995;132:727–9. ISSN 0804–4643 Information on the course and outcome of pregnancies in growth hormone (GH)-deficient patients is sparse, and GH treatment during pregnancy in such women has not been described previously. We have studied fetal growth and serum levels of GH, insulin-like growth factor I (IGF-I) and IGF binding protein 3 (IGFBP-3) during pregnancy, as well as birth weight and hormone levels after delivery in a 2 5-year-old woman with idiopathic, isolated GH deficiency diagnosed at the age of 7 years. As part of a clinical trial, the patient was treated with 2 IU/M2 GH for a period of 5 years. At this time she became pregnant after donor insemination. The GH treatment was continued until variant GH production from the placenta was evident. Serum levels of GH, IGF-I and IGFBP-3 were measured monthly during pregnancy after 3 days off GH therapy. Abdominal ultrasound was performed five times. Hormonal levels were measured immediately after delivery and during the following days. Serum GH and IGF-I levels increased during the second half of pregnancy: serum IGFBP-3 remained constant throughout pregnancy at a normal level. Serum levels of GH fell within 1 h after delivery, and levels of IGF-I and IGFBP-3 decreased into the range of GH-deficient women 4 days after. The fetal biparietal diameter increased normally, and birthweight was 3.564kg, length 52 cm. No adverse events were recorded. We conclude that the role of GH replacement during pregnancy of GH-deficient women should be investigated further. Jørn Müller, Department of Growth and Reproduction, GR 5064, Rigshospitalet, 9 Blegdamsvej, DK-2100 Copenhagen ø, Denmark

scholarly journals Serum markers of GH and insulin action in 12-year-old children born small for gestational age

2005 ◽  
Vol 152 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Sirpa Tenhola ◽  
Pirjo Halonen ◽  
Jarmo Jääskeläinen ◽  
Raimo Voutilainen
Keyword(s):  
Blood Glucose ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Insulin Action ◽  
The Body ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Serum Concentrations ◽  
Igf I ◽  
Igfbp 3

Objectives: Our aim was to determine whether markers of growth hormone and insulin action differ between children born small for gestational age (SGA) and those born of an appropriate size for gestational age (AGA). Design: Fifty-five SGA children and their 55 age- and sex-matched AGA control subjects were studied in a case-control setting at 12 years of age. Methods: We examined serum concentrations of insulin-like growth factor (IGF)-I, IGF-II, IGF-binding protein (IGFBP)-1 and IGFBP-3, sex hormone binding globulin (SHBG), leptin, fasting insulin, and blood glucose. Insulin sensitivity was evaluated by the homeostasis model assessment for insulin resistance (HOMA-IR). Results: The body mass index (BMI), sex, and puberty-adjusted mean serum IGF-I concentration was higher in the SGA than in the AGA children (303.4 vs 282.3 μg/l, P = 0.006). The mean serum concentrations of IGF-II, IGFBP-I, IGFBP-3, SHBG, fasting insulin, blood glucose and HOMA-IR did not differ between the SGA and the AGA group. The BMI, sex, and puberty-adjusted mean serum leptin concentration was lower in the SGA than in the AGA children (7.9 vs 10.1 μg/l, P = 0.037). In multiple logistic regression analysis, high HOMA-IR predicted high serum IGF-I levels in the SGA children (odds ratio 8.3; 95% confidence interval 1.7–41; P = 0.010), whereas in the AGA group HOMA-IR did not associate with the serum IGF-I level. Conclusions: The BMI, sex, and puberty-adjusted mean serum IGF-I concentration was significantly higher and the leptin concentration was lower in the SGA than in the AGA children. No differences were found in the indices of insulin action or sensitivity between the SGA and AGA children at 12 years of age. However, HOMA-IR strongly associated with serum IGF-I levels in the SGA children.

Transitional Hypoglycaemia Management in Small for Gestational Age Neonates with Sucrose Enriched Expressed Breastmilk in Resource Poor Setting

2019 ◽  
Vol 66 (3) ◽  
pp. 267-274
Author(s):  
Reeta Bora ◽  
Sumon Deori
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Therapy Group ◽  
Resource Poor Setting ◽  
Oral Supplementation ◽  
Resource Poor ◽  
Calculated Dose ◽  
Group A ◽  
Feed Intolerance ◽  
Group B

Abstract Aim To find out if oral sucrose is as efficacious as intravenous dextrose (IVDx) in treating hypoglycaemia in small for gestational age (SGA) neonates and to compare risk of feed intolerance (FI) and necrotizing enterocolitis (NEC) in oral therapy with IVDx therapy. Methods Eighty SGA haemodynamically stable hypoglycaemic [blood sugar (BS) &lt; 40 mg/dl] neonates of ≥32 to ≤36 week gestational age were randomized to receive oral sugar enriched expressed breastmilk (EBM; Group A) or IV dextrose therapy (Group B; 40 in each group) in similar calculated doses. BS at 6 h after treatment, incidence of recurrence of hypoglycaemia, FI and NEC were compared. Results Mean BS level at 6 h after treatment in oral supplementation group was 63.53 ± 22.12 mg/dl [3.52 ± 1.22 mmol/l (IQR 49.2–82 mg/dl, 2.7–4.5 mmol/l) vs. 71.28 ± 31.76 mg/dl [3.96 ± 1.76 mmol/l (IQR 48.5–73 mg/dl, 2.69–4 mmol/l) in IVDx group, p = 0.209. Relative risk (RR) of recurrence of hypoglycaemia in oral vs. IV treatment was 1.5 with 95% CI 0.4578–4.9151. Incidence of FI (p = 0.49, RR 1, 95%CI 0.3–3.1) and NEC (p = 0.4, RR 0.2, 95%CI 0.01–4.2) was comparable Conclusion In resource poor setting in haemodynamically stable hypoglycaemic SGA neonates, EBM enriched with calculated dose of sucrose given orally maintains euglycaemia (BS 40–125mg/dl, 2.2–6.9 mmol/l) without increased incidence of FI and NEC. This method also prevents lactational failure.

scholarly journals Comparison between methyldopa and combination of methyldopa and nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension

2021 ◽  
Vol 15 (7) ◽  
pp. 1703-1705
Author(s):  
Bilqees Akhtar Malik ◽  
Shahzad Bashir Momina ◽  
Tazeen Ashraf
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Age ◽  
Low Dose ◽  
High Dose ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
In Pregnancy

Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled trial was conducted at Department of Obstetrics and Gynecology, Combined Military Hospital Bahawalpur from February 2020 to August 2020 over the period of 6 months. Total 80 patients with pregnancy induced hypertension as per operational definition having age 20-40 years and having gestational age ≥ 20 weeks assessed on LMP were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 30.65 ± 5.65 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension. Keywords: Diastolic blood pressure, Methyldopa, Nifedipine, Pregnancy induced hypertension, Systolic blood pressure

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