scholarly journals Growth Hormone/Insulin-Like Growth Factor-1 
Axis as Related to Body Mass Index in Patients with Idiopathic Short Stature

2013 ◽  
Vol 5 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Cengiz Pınar ◽  
Baş Firdevs ◽  
Atalar Fatmahan ◽  
Uçar Ahmet ◽  
Darendeliler Feyza ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Growth Factor ◽  
Short Stature ◽  
Body Mass ◽  
Idiopathic Short Stature ◽  
Insulin Like Growth Factor

Etiology of short stature in Indian children and an assessment of the growth hormone-insulin-like growth factor axis in children with idiopathic short stature

2018 ◽  
Vol 31 (9) ◽  
pp. 1009-1017 ◽  
Author(s):  
Anil Kumar ◽  
Ankita Pal ◽  
Mani Kalaivani ◽  
Nandita Gupta ◽  
Vandana Jain
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Short Stature ◽  
Idiopathic Short Stature ◽  
Insulin Like Growth Factor ◽  
Indian Children ◽  
Igf Binding ◽  
The Mean ◽  
Igf Binding Protein ◽  
Igfbp 3

Abstract Background Our objectives were to evaluate the etiology of short stature, assess the prevalence of idiopathic short stature (ISS) and assess the growth hormone (GH)-insulin-like growth factor (IGF) axis in children with ISS. Methods A stepwise diagnostic evaluation was done in 394 children aged 4–16 years with short stature. Children with no definitive etiology were labeled as ISS. In these children, baseline IGF-1, IGF binding protein-3 (IGFBP-3) and stimulated IGF-1 after administration of GH for 4 days were measured. Results Hypothyroidism (in 18.1%) and ISS (in 15.5%) were the commonest causes of short stature. In children with ISS (n=61), the mean baseline and stimulated IGF-1 standard deviation scores (SDSs) were −1.2±1.0 and −0.3±1.4, respectively, with levels below −2 SDS in 13 (21%) and six (10%) children, respectively. In 33 (54%) of the ISS patients, response to GH was suboptimal (increment in the IGF-1 level <40%). There was no difference in the mean peak GH, IGFBP-3 and baseline and stimulated IGF-1 levels between children with familial and non-familial ISS. A significant positive correlation of height SDS with baseline IGF-1 SDS (r=0.28, p=0.026), stimulated IGF-1 SDS (r=0.32, p=0.010) and ΔIGF-1 SDS (r=0.26, p=0.036) was observed in children with ISS. Conclusions Hypothyroidism and ISS were the commonest etiologies for short stature. The baseline IGF-1 was below −2 SDS in 21% and the increment after GH stimulation was suboptimal in 54% of children, indicating that a substantial proportion of children with ISS had an impaired GH-IGF axis.

Growth response to growth hormone (GH) treatment in children with GH deficiency (GHD) and those with idiopathic short stature (ISS) based on their pretreatment insulin-like growth factor 1 (IGFI) levels and at diagnosis and IGFI increment on treatment

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ashraf Soliman ◽  
Alan D. Rogol ◽  
Sohair Elsiddig ◽  
Ahmed Khalil ◽  
Nada Alaaraj ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Standard Deviation ◽  
Growth Factor ◽  
Short Stature ◽  
Linear Growth ◽  
Standard Deviation Score ◽  
Idiopathic Short Stature ◽  
Insulin Like Growth Factor ◽  
Gh Therapy ◽  
Deviation Score

Abstract Objectives Some idiopathic short stature (ISS) patients may have varying degrees of insulin-like growth factor 1 (IGFI) deficiency. Others with growth hormone deficiency (GHD) (peak GH < 7 ng/dL after provocation) have normal IGFI levels. Do children with ISS or those with GHD with variable pretreatment IGFI standard deviation score (IGFISDS) have different IGFI and growth responses to recombinant human growth hormone (rhGH) therapy? Methods We studied the effect of GH therapy (0.035–0.06 mg/kg/day) on linear growth and weight gain per day (WGPD) in children with ISS (n=13) and those with GHD (n=10) who have low pretreatment IGFISDS (IGF SDS < −1.5) and compared them with age-matched prepubertal children with ISS (n=10) and GHD (n=17) who had normal pretreatment IGFISDS. An untreated group of children with ISS (n=12) served as a control group. Results At presentation, the height standard deviation score (HtSDS) of children with ISS who had low pretreatment IGFISDS was significantly lower compared to the normal IGFI group. The age, body mass index (BMI), BMISDS, peak GH response to clonidine provocation and bone age did not differ between the two study groups. After 1 year of treatment with rhGH (0.035–0.06 mg/kg/day) IGFISDS increased significantly in both groups (p<0.05). Both had significantly increased HtSDS (catch-up growth). The increase in the HtSDS and WGPD were significantly greater in the lower pretreatment IGFISDS group. The IGFSDS, BMISDS, HtSDS and difference between HtSDS and mid-parental HtSDS were significantly greater in the rhGH treated groups vs. the not treated group. In the GHD groups (normal and low IGFISDS), after 1 year of GH therapy (0.03–0.05 mg/kg/day), the HtSDS increased significantly in both, (p<0.01). The WGPD and increment in BMI were significantly greater in children who had low pretreatment IGFISDS. There was a significant increase in the IGFSDS in the two treated groups (p<0.05), however, the WGPD was greater in the pretreatment low IGFISDS. Conclusions IGFI deficiency represents a low anabolic state. Correction of IGFI level (through rhGH and/or improved nutrition) in short children (ISS and GHD) was associated with increased linear growth and WGPD denoting significant effect on bone growth and muscle protein accretion.

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