Utility of insulin-like growth factor-1 (IGF-1) in growth hormone-treated short children – An experience from a tertiary level center

Vaman Khadilkar, Chirantap Oza, Shruti Mondkar, Anuradha Khadilkar
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Abstract

Introduction: Very few studies have been conducted in low-middle-income countries to assess the response to growth hormone (GH) therapy by measuring the improvement in insulin-like growth factor-1 (IGF-1) concentrations. Objectives: The objective is to assess IGF-1 concentrations in patients receiving GH therapy to correlate the height increment with respect to increase in the IGF-1 concentrations, including IGF-1 Z-scores as a measure of safety profile. Methods: Clinical and anthropometric data were extracted retrospectively from hospital records of children aged 0–18 who received GH and had IGF-1 measured during the study period. Serum IGF-1 concentrations were analyzed by a solid-phase enzyme-linked immunosorbent assay. Patients with GH deficiency (GHD) and multiple pituitary hormone deficiency (MPHD) were grouped as group A, while participants receiving GH therapy for non-GHD/MPHD were clubbed as group B. Results: We report a significant positive correlation between an increase in IGF-1 values and increase in height. The improvement in height Z-scores was significantly higher in participants of group A as compared to B, with no significant difference in increase in IGF-1 Z-scores between the two groups. A total of 18.75% of subjects had IGF-1 Z-scores between +2 and +3, and these were largely subjects belonging to group B. Conclusion: The increment in height and height velocity Z-scores in the patients on GH correlated with increase in the IGF-1 concentrations, particularly in GHD/MPHD group of patients.
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胰岛素样生长因子-1(IGF-1)在接受生长激素治疗的矮小儿童中的应用--一家三级医疗中心的经验之谈
导言:在中低收入国家,很少有研究通过测量胰岛素样生长因子-1(IGF-1)浓度的改善情况来评估生长激素(GH)疗法的反应。目标:目的是评估接受 GH 治疗患者的 IGF-1 浓度,将身高的增长与 IGF-1 浓度的增长联系起来,包括 IGF-1 Z 分数,作为衡量安全性的标准。研究方法从医院记录中回顾性地提取了在研究期间接受过 GH 并测量过 IGF-1 的 0-18 岁儿童的临床和人体测量数据。血清 IGF-1 浓度通过固相酶联免疫吸附试验进行分析。GH缺乏症(GHD)和多发性垂体激素缺乏症(MPHD)患者被归为A组,而接受GH治疗的非GHD/MPHD患者被归为B组。结果我们发现 IGF-1 值的增加与身高的增加之间存在明显的正相关。与 B 组相比,A 组参与者身高 Z 值的提高幅度明显更高,而两组之间 IGF-1 Z 值的提高幅度没有明显差异。共有 18.75% 的受试者的 IGF-1 Z 值介于 +2 和 +3 之间,这些受试者主要属于 B 组:服用 GH 的患者身高和身高速度 Z 值的增加与 IGF-1 浓度的增加有关,尤其是在 GHD/MPHD 组患者中。
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