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Serum IGF-I concentrations are low in female bodybuilders in the pre-contest phase 女性健美运动员在赛前阶段血清igf - 1浓度较低
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101420
Diana Paula Pandochi Fernandes Monteiro , Marcos Correa Jr , Thomaz Talarico Neto , Carlos Eduardo Martinelli Jr , Hugo Tourinho Filho

Bodybuilding involves athletes performing a series of poses/postures on the stage so that they can be classified according to their best esthetic and physical appearance during the competition. In the weeks prior to the target competition, the athletes subject themselves to restrictive diets and different physical training methods, as well as using dietary supplementation and, in some cases, anabolic steroids, to reduce body fat to low levels and maintain or increase muscle mass. On the other hand, it is known that physical training is a potent stimulator for releasing the components of the GH/IGF-I axis that are directly linked to the anabolic process. Based on these assumptions, this study aimed to verify the kinetics of IGF-I and of its binding protein IGFBP-3 in female bodybuilders. Serum IGF-I and IGFBP-3 concentrations were recorded before and after standardized training sessions at two different times: in the initial phase (phase 1) and in the final phase of the pre-contest (phase 2) of a 12-week training season. It was possible to conclude that there was a significant reduction in serum IGF-I values at the end of the pre-contest phase that preceded the athletes' participation in a competition. With relation to the serum IGF-I and IGFBP-3 values measured before and after the standardized training session, it was only possible to verify significant changes in the IGF-I values in the initial phase of the pre-contest. It seems reasonable to suggest that the caloric restriction used by bodybuilders may be related to the decrease in IGF-I values verified at the end of the pre-contest phase.

健美包括运动员在舞台上表演一系列姿势,以便在比赛中根据他们的最佳审美和身体外观进行分类。在目标比赛开始前的几周,运动员们接受限制性饮食和不同的体能训练方法,同时使用膳食补充剂,在某些情况下使用合成代谢类固醇,以将体脂减少到低水平,保持或增加肌肉质量。另一方面,众所周知,体育训练是释放与合成代谢过程直接相关的GH/IGF-I轴成分的有效刺激物。基于这些假设,本研究旨在验证女性健美运动员体内igf - 1及其结合蛋白IGFBP-3的动力学。在标准化训练前后的两个不同时间分别记录血清IGF-I和IGFBP-3浓度:12周训练季的初始阶段(第1阶段)和赛前最后阶段(第2阶段)。可以得出结论,在运动员参加比赛之前的赛前阶段结束时,血清IGF-I值显着降低。与标准化训练前后测量的血清IGF-I和IGFBP-3值的关系,只能验证IGF-I值在赛前初始阶段的显著变化。似乎有理由认为,健美运动员使用的热量限制可能与赛前阶段结束时验证的IGF-I值的降低有关。
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引用次数: 0
Relationship between circulating insulin-like growth factor-1 and blood pressure in adults: A systematic review and meta-analysis of observational studies 成人循环胰岛素样生长因子-1与血压的关系:观察性研究的系统回顾和荟萃分析
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101416
Lina Leng , Yuling Xing , Yi Liang , Chang Wang , Huijuan Ma

Objective

Insulin-like growth factor 1 (IGF-1) is an important factor related to cardiovascular disease. In recent years, studies have shown the involvement of IGF-1 and blood pressure (BP). Nevertheless, the results were inconsistent. Thus, the purpose of this study was to systematically evaluate the associations of circulating IGF-1 levels with BP in adults.

Methods

Two reviewers independently searched and screened articles from the Pubmed, EMBASE, Cochrane Library, CNKI, and WANFANG databases up to May 2020. A total of 12 studies that reported the correlation coefficients between IGF-1, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were included.

Results

IGF-1 was significantly correlated with SBP [r = −0.15; 95% CI = −0.21, −0.08; P < 0.0001] and DBP [r = −0.10; 95% CI = −0.16, −0.05; P = 0.0004]. Subgroup analysis further revealed that the relationship between IGF-1 and BP was influenced by race and age.

Conclusion

Circulating IGF-1 was negatively correlated with SBP and DBP. Further researches are necessary to explore the pathogenesis of this relationship and to evaluate the role of IGF-1 in the treatment of hypertension.

目的胰岛素样生长因子1 (IGF-1)是心血管疾病的重要相关因子。近年来,研究表明IGF-1与血压(BP)有关。然而,结果并不一致。因此,本研究的目的是系统地评估成人血液中IGF-1水平与血压的关系。方法两名审稿人独立检索并筛选了截至2020年5月的Pubmed、EMBASE、Cochrane Library、CNKI和万方数据库中的文章。共有12项研究报告了IGF-1与收缩压(SBP)和舒张压(DBP)之间的相关系数。结果igf -1与收缩压呈显著相关[r = - 0.15;95% ci = - 0.21, - 0.08;P & lt;0.0001]和DBP [r =−0.10;95% ci =−0.16,−0.05;p = 0.0004]。亚组分析进一步发现IGF-1与BP的关系受种族和年龄的影响。结论循环IGF-1与收缩压、舒张压呈负相关。这一关系的发病机制以及IGF-1在高血压治疗中的作用有待进一步研究。
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引用次数: 1
RNA-seq and nuclear proteomics provide insights into the lactation regulation mechanism of goat transfected IGF-I and GH recombinant vectors RNA-seq和核蛋白质组学研究揭示了IGF-I和GH重组载体对山羊泌乳的调控机制
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101428
Shaodong Fu , Xuehuai Shen , Xudong Wang , Yilin Zhou , Jinqiu Zhang , Jinfeng Miao

There exists little available information on the mechanisms of lactation regulation until now. In order to explore the underlying mechanism, we injected IGF-I and GH recombinant vectors into the mammary gland, then RNA-seq analysis and nuclear proteomics were used for rapid high-throughput screening of DEGs and DEPs in the two groups linked to lactation regulation. KEGG analysis of 206 DEGs showed that the same 4 of top 10 enrichment pathways (ECM receptor interaction, protein digestion and absorption, focal adhesion and phagosome) involved in 4 co-expressed genes (IDO, BTG1, ITGB6 and keratin 83), the two groups enriched different metabolic pathways yet. Nuclear proteomics analysis showed 75 and 36 DEPs in the IGF-I and GH group respectively; Sixteen common proteins were identified between the IGF-I group and GH group, four of which (ALB, TPT1, CXXC-5 and ACTR2) significantly decreased and three of which (PRP1, PAG-9 and Hsp70) significantly increased. Similarly, DEPs in the two groups were enriched in same one of top 10 enrichment pathways (PI3K-Akt signaling pathway). Protein-protein interaction networks highlighted the contribution of glycosphingolipid biosynthesis, porphyrin and chlorophyll metabolism and the Jak-STAT signaling pathway to lactation regulation of GH and IGFI. GH and IGF-I improve milk yield, which may be linked to important nodal proteins (ALB and ACTB). Our research advances the understanding of the mammary gland transcriptome and nuclear proteomics during GH and IGF-I overexpression. Individual genes, proteins and pathways in this study point towards potential targets for lactation regulation.

迄今为止,关于哺乳调节机制的信息很少。为了探索其潜在机制,我们将IGF-I和GH重组载体注入乳腺,然后利用RNA-seq分析和核蛋白质组学快速高通量筛选两组中与泌乳调节相关的deg和dep。206个DEGs的KEGG分析显示,前10条富集途径(ECM受体相互作用、蛋白质消化吸收、局灶黏附和吞噬体)中有4条涉及4个共表达基因(IDO、BTG1、ITGB6和角蛋白83),但两组富集的代谢途径不同。核蛋白质组学分析显示IGF-I组和GH组分别有75和36个DEPs;igf - 1组与GH组共有16个蛋白,其中4个蛋白(ALB、TPT1、CXXC-5、ACTR2)显著降低,3个蛋白(PRP1、PAG-9、Hsp70)显著升高。同样,两组的DEPs在前10条富集通路(PI3K-Akt信号通路)中富集相同。蛋白质-蛋白质相互作用网络强调了鞘糖脂生物合成、卟啉和叶绿素代谢以及Jak-STAT信号通路对GH和IGFI泌乳调节的贡献。生长激素和igf - 1可以提高产奶量,这可能与重要的节点蛋白(ALB和ACTB)有关。我们的研究促进了对GH和IGF-I过表达过程中乳腺转录组和核蛋白质组学的理解。本研究中的个体基因、蛋白和途径指向了哺乳调节的潜在靶点。
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引用次数: 0
GHRH expression plasmid improves osteoporosis and skin damage in aged mice GHRH表达质粒改善老年小鼠骨质疏松和皮肤损伤
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101429
Rui Ye, Hai-long Wang, De-Wei Zeng, Ting Chen, Jia-Jie Sun, Qian-Yun Xi, Yong-Liang Zhang

The hormone secretion of GHRH-GH-IGF-1 axis in animals was decreased as aging. These hormones play an important role in maintaining bone mass and bone structure, and also affect the normal structure and function of the skin. We used plasmid-based technology to deliver growth hormone releasing hormone (GHRH) to elderly mice. In the current study, 80 and 120 μg/kg pVAX-GHRH plasmid expression plasmid were injected into old mice, the serum GHRH and insulin-like growth factor-1(IGF-1) content were increased within three weeks (P < 0.05). In the groups of 80 and 120 μg/kg plasmid, the content of procollagen type I N-terminal pro-peptide (PINP) in the serum was increased(P < 0.05), and the content of C-terminal telopeptides of type I collagen (CTX-1) in the serum was reduced significantly (P < 0.05). Furthermore, the expression of osteoprotegerin (OPG) and osteocalcin (OCN) in the femur also was increased(P < 0.05). The bone mineral density(BMD)、trabecular bone volume (BV/TV) and trabecular number(Tb.N) of mouse femur were increased significantly (P < 0.05) and trabecular separation(Tb.Sp) was decreased(P < 0.05). There were more trabecular bones in the bone marrow cavity and the trabecular bones are thicker in the groups of 80 and 120 μg/kg plasmid relative to control. The superoxide dismutase (SOD) content in the skin was increased(P < 0.05), and the malondialdehyde (MDA) content was reduced significantly (P < 0.05). Meanwhile, the skin moisture content also increased significantly(P < 0.05). Moreover, the expression of matrix metalloproteinase 3(MMP3) and matrix metalloproteinase 9(MMP9) was decreased in the skin(P < 0.05). The thickness of the dermis and epidermis of the skin had increased significantly(P < 0.05). Skin structure is more dense and complete in the two groups. These results indicate that 80 and 120 μg/kg plasmid-mediated GHRH supplementation can improve osteoporosis and skin aging in aged mice.

动物GHRH-GH-IGF-1轴的激素分泌随着年龄的增长而减少。这些激素在维持骨量和骨结构方面起着重要作用,也影响皮肤的正常结构和功能。我们使用基于质粒的技术向老年小鼠输送生长激素释放激素(GHRH)。本研究将80和120 μg/kg的pVAX-GHRH表达质粒注射到老年小鼠体内,3周内血清GHRH和胰岛素样生长因子-1(IGF-1)含量升高(P <0.05)。80和120 μg/kg质粒组血清中I型前胶原n端前肽(PINP)含量升高(P <0.05),血清中I型胶原c端末端肽(CTX-1)含量显著降低(P <0.05)。此外,股骨中骨保护素(OPG)和骨钙素(OCN)的表达也增加(P <0.05)。小鼠股骨骨密度(BMD)、骨小梁体积(BV/TV)和骨小梁数目(Tb.N)显著升高(P <0.05),小梁分离(Tb.Sp)降低(P <0.05)。80和120 μg/kg质粒组小鼠骨髓腔内骨小梁较多,骨小梁较对照组粗。皮肤中超氧化物歧化酶(SOD)含量升高(P <0.05),丙二醛(MDA)含量显著降低(P <0.05)。同时,皮肤水分含量也显著增加(P <0.05)。此外,基质金属蛋白酶3(MMP3)和基质金属蛋白酶9(MMP9)在皮肤中的表达降低(P <0.05)。真皮和表皮的厚度显著增加(P <0.05)。两组皮肤结构更为致密和完整。由此可见,80和120 μg/kg质粒介导的GHRH可改善老年小鼠骨质疏松和皮肤老化。
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引用次数: 2
Adult height and long-term outcomes after rhIGF-1 therapy in two patients with PAPP-A2 deficiency 2例PAPP-A2缺乏症患者的成人身高和长期预后
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101419
Álvaro Martín-Rivada , Vicente Barrios , Guillermo Martínez Díaz-Guerra , Jesús Pozo , Gabriel Ángel Martos-Moreno , Jesús Argente

PAPP-A2 deficiency is a novel syndrome characterized by short stature due to low IGF bioactivity, skeletal abnormalities and decreased bone mineral density (BMD). Treatment with recombinant human IGF-1 (rhIGF-1) for 1 year demonstrated to increase growth velocity and BMD, without reported adverse effects, but data regarding the long-term efficacy and safety of rhIGF-1 administration in this entity has not yet been reported.

Two Spanish siblings with short stature due to a homozygous loss-of-function mutation in the PAPP-A2 gene (p.D643fs25*) were treated with rhIGF-1 twice daily for six years. Growth velocity continued to increase and both patients achieved their target height. Free IGF-1 concentrations increased notably after rhIGF-1 administration, with serum IGFBP-3, IGFBP-5 and ALS levels also being higher during treatment. BMD was progressively normalized and an increase in lean mass was also noted during treatment. No episodes of hypoglycemia or any other adverse effects were documented. An increase in the growth of kidney and spleen length was observed in one of the patients.

PAPP-A2缺乏症是一种新型综合征,其特征是由于IGF生物活性低、骨骼异常和骨密度降低而导致身材矮小。用重组人IGF-1 (rhIGF-1)治疗1年证明可以增加生长速度和骨密度,没有报道的不良反应,但关于rhIGF-1在该实体中的长期疗效和安全性的数据尚未报道。由于PAPP-A2基因纯合子功能缺失突变(p.D643fs25*)导致身材矮小的两个西班牙兄弟姐妹接受了rhIGF-1治疗,每天两次,持续六年。生长速度持续加快,两例患者均达到了目标身高。服用rhIGF-1后,游离IGF-1浓度显著升高,血清IGFBP-3、IGFBP-5和ALS水平也在治疗期间升高。在治疗期间,骨密度逐渐正常化,瘦体重也有所增加。没有记录低血糖发作或任何其他不良反应。其中一名患者的肾脏和脾脏的生长都有所增加。
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引用次数: 2
Effects of raloxifene administration on serum levels of insulin-like growth factor-1 and insulin-like growth factor-binding protein 3 levels: A systematic review and meta-analysis of randomized controlled trials 雷洛昔芬对血清胰岛素样生长因子-1和胰岛素样生长因子结合蛋白3水平的影响:随机对照试验的系统回顾和荟萃分析
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101421
Yan Sun , Ying Xiong , Yong Liang Meng , Heitor O. Santos , Felipe L. Athayde , Ivan G.O. de Souza , Ling Yang

Objective

To ascertain the clinical magnitude of raloxifene administration on insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein 3 (IGFBP-3) levels.

Methods

A systematic comprehensive search was performed without language limitation up to 14 December 2020. We included only trials that assessed the effect of raloxifene on IGF-1 and IGFBP-3 in adults. Meta-analysis was performed using the Stata software (Stata Corp. College Station, Texas, USA).

Results

Seven arms were included, encompassing postmenopausal women with type 2 diabetes mellitus, postmenopausal women with breast cancer, healthy postmenopausal women, and healthy elderly men. Raloxifene therapy significantly reduced IGF-1 levels (WMD: −2.92 nmol/L, 95% CI: −3.49, −2.35, p < 0.001) compared to placebo. Raloxifene dosage ˃60 mg/day (WMD: −3.29 ng/mL, 95% CI: −3.50 to −3.08, I2 = 0.0%) decreased IGF-1 levels more than 60 mg/day (WMD: −2.29 ng/mL, 95% CI: −2.90 to −1.69, I2 = 16%). Moreover, intervention duration ˃26 weeks (WMD: −3.48 ng/mL, 95% CI: −5.26 to −1.69, I2 = 0.0%) reduced IGF-1 levels more than ˂26 weeks (WMD: −2.55 ng/mL, 95% CI: −3.31 to −1.79, I2 = 92%). In contrast, overall results from the random-effects model did not suggest a significant change in IGFBP-3 levels upon raloxifene therapy.

Conclusion

Raloxifene therapy significantly reduced serum levels of IGF-1 levels but without changes in IGFPB-3 levels.

目的探讨雷洛昔芬对胰岛素样生长因子-1 (IGF-1)和胰岛素样生长因子结合蛋白3 (IGFBP-3)水平的影响。方法截至2020年12月14日,进行无语言限制的系统综合检索。我们只纳入了评估雷洛昔芬对成人IGF-1和IGFBP-3影响的试验。meta分析采用Stata软件(Stata Corp. College Station, Texas, USA)。结果纳入7组,包括绝经后2型糖尿病妇女、绝经后乳腺癌妇女、健康绝经后妇女和健康老年男性。雷洛昔芬治疗显著降低IGF-1水平(WMD:−2.92 nmol/L, 95% CI:−3.49,−2.35,p <0.001)。雷洛昔芬剂量≤60 mg/天(WMD:−3.29 ng/mL, 95% CI:−3.50 ~−3.08,I2 = 0.0%)可降低IGF-1水平(WMD:−2.29 ng/mL, 95% CI:−2.90 ~−1.69,I2 = 16%)。此外,干预时间≤26周(WMD:−3.48 ng/mL, 95% CI:−5.26 ~−1.69,I2 = 0.0%)比≤26周(WMD:−2.55 ng/mL, 95% CI:−3.31 ~−1.79,I2 = 92%)降低了IGF-1水平。相比之下,随机效应模型的总体结果并未显示雷洛昔芬治疗后IGFBP-3水平有显著变化。结论雷洛昔芬治疗可显著降低血清IGF-1水平,但对IGFPB-3水平无明显影响。
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引用次数: 2
The effect of milk and rapeseed protein on growth factors in 7–8 year-old healthy children – A randomized controlled trial 牛奶和菜籽蛋白对7-8岁健康儿童生长因子的影响——一项随机对照试验
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101418
Benedikte Grenov, Anni Larnkjær, Christian Ritz, Kim F. Michaelsen, Camilla T. Damsgaard, Christian Mølgaard

Objective: Milk protein may stimulate linear growth through insulin-like growth factor-1 (IGF-1). However, the effect of plant proteins on growth factors is largely unknown. This study assesses the effect of combinations of milk and rapeseed protein versus milk protein alone on growth factors in children.

Design: An exploratory 3-armed randomized, double-blind, controlled trial was conducted in 129 healthy 7–8 year-old Danish children. Children received 35 g milk and rapeseed protein (ratio 54:46 or 30:70) or 35 g milk protein per day for 4 weeks. The primary outcome was difference in IGF-1 changes between intervention groups after 4 weeks. Secondary outcomes included changes in IGF-1 after 1 week and changes in insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3, insulin, height, weight and body composition after 1 and 4 weeks. Results were analysed by multiple linear mixed-effect models.

Results: There were no differences in changes of plasma IGF-1, insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3 ratio or insulin between groups after 1 or 4 weeks based on 89 complete cases (P > 0.10). IGF-1 increased by 13.7 (95% CI 9.7;17.7) ng/mL and 18.0 (14.0;22.0) ng/mL from baseline to week 1 and 4, respectively, a 16% increase during the intervention. Similarly, insulin increased by 31% (14; 50) and 33% (16; 53) from baseline to week 1 and 4. Fat-free mass index (FFMI) increments were higher with milk alone than rapeseed blends (P < 0.05), coinciding with a trend towards a lower height increment. Body mass index increased within all groups (P < 0.05), mainly due to an increase in FFMI (P < 0.01).

Conclusion: There were no differences in changes of growth factors between the combinations of milk and rapeseed protein and milk protein alone in healthy, well-nourished children with a habitual intake of milk. Within groups, growth factors increased considerably. Future studies are needed to investigate how intakes of plant and animal proteins affect childhood growth.

目的:牛奶蛋白可能通过胰岛素样生长因子-1 (IGF-1)刺激线性生长。然而,植物蛋白对生长因子的影响在很大程度上是未知的。本研究评估了牛奶和菜籽蛋白组合与单独牛奶蛋白对儿童生长因子的影响。设计:对129名7-8岁丹麦健康儿童进行了一项探索性三臂随机、双盲、对照试验。儿童每天摄入35克牛奶和菜籽蛋白(比例54:46或30:70)或35克牛奶蛋白,持续4周。主要结局是干预组间4周后IGF-1变化的差异。次要结局包括1周后IGF-1的变化,1周和4周后胰岛素样生长因子结合蛋白3 (IGFBP-3)、IGF-1/IGFBP-3、胰岛素、身高、体重和体成分的变化。结果采用多元线性混合效应模型进行分析。结果:89例患者术后1、4周血浆IGF-1、胰岛素样生长因子结合蛋白-3 (IGFBP-3)、IGF-1/IGFBP-3比值及胰岛素水平在两组间无明显差异(P >0.10)。从基线到第1周和第4周,IGF-1分别增加了13.7 (95% CI 9.7;17.7) ng/mL和18.0 (14.0;22.0)ng/mL,干预期间增加了16%。同样,胰岛素增加了31% (14;50)和33% (16;53)从基线到第1周和第4周。无脂质量指数(FFMI)增量单独添加牛奶高于混合添加油菜籽(P <0.05),与较低的高度增量趋势一致。各组体重指数均升高(P <0.05),主要是由于FFMI增加(P <0.01)。结论:习惯摄入牛奶的健康、营养良好的儿童,牛奶加菜籽蛋白与单独使用牛奶蛋白的生长因子变化无差异。在组内,生长因子显著增加。未来的研究需要调查植物和动物蛋白质的摄入如何影响儿童生长。
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引用次数: 4
The necessity of magnetic resonance imaging in the evaluation of pediatric growth hormone deficiency: Lessons from a large academic center 磁共振成像在儿童生长激素缺乏症评估中的必要性:来自大型学术中心的经验教训
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101427
Leena Mamilly , Amy L. Pyle-Eilola , Monika Chaudhari , Rohan K. Henry

Background

Current guidelines indiscriminately recommend magnetic resonance imaging (MRI) of the pituitary gland in pediatric growth hormone deficiency (GHD). The relationship between abnormal MRI, most importantly a tumor, and peak GH levels is not well known.

Methods

In this retrospective chart review, pituitary MRI results of children, ages of 3–16 years with GHD were collected and divided into 3 groups according to peak stimulated GH levels; ≤5, 5–7.4 and 7.5–10 ng/mL, Groups A, B & C respectively. Clinical and MRI findings were compared between the groups.

Results

A total of 399 children were included. Abnormal MRI was found in 36.9% of group A subjects, compared to group B (16.7%) and group C (17.0%), both p values =0.0002. Children with multiple pituitary hormonal deficiencies (MPHD) had a higher rate of abnormalities than those with isolated GHD. Children with isolated GHD were more likely to have abnormal MRI with peak GH level < 5 ng/mL compared to those with levels, 5–7.4 & 7.5–10 ng/mL. 4 children in group A had a craniopharyngioma. ROC analysis comparing peak GH levels with abnormal MRI findings showed an area under the curve (AUC) of 0.614 and 0.728 for IGHD and MPHD, respectively.

Conclusion

Although abnormal MRI was found in all 3 study groups, it was more likely at GH level < 5 ng/mL and in children with MPHD. To avoid missing a tumor, the importance of imaging in children with GHD and peak GH levels <5 ng/mL cannot be overemphasized.

背景:目前的指南不加区分地推荐儿童生长激素缺乏症(GHD)的垂体磁共振成像(MRI)。异常MRI(主要是肿瘤)与生长激素峰值水平之间的关系尚不清楚。方法回顾性收集3 ~ 16岁儿童GHD的垂体MRI结果,根据刺激激素峰值水平分为3组;≤5,5 - 7.4和7.5-10 ng/mL, A组,B组和;C分别。比较两组患者的临床和MRI表现。结果共纳入399例患儿。A组MRI异常发生率为36.9%,B组为16.7%,C组为17.0%,p值均为0.0002。多发性垂体激素缺乏症(MPHD)患儿的异常发生率高于单纯GHD患儿。孤立性GHD患儿更有可能出现异常MRI和GH峰值;5 ng/mL与5 - 7.4水平的人相比;7.5 -10 ng / mL。A组4例患儿发生颅咽管瘤。将GH峰值水平与异常MRI结果进行ROC分析,IGHD和MPHD的曲线下面积(AUC)分别为0.614和0.728。结论虽然3个研究组均有MRI异常,但以GH水平的MRI异常居多;5ng /mL和MPHD儿童。为避免遗漏肿瘤,对GHD患儿和GH峰值水平(≤5ng /mL)进行影像学检查的重要性再怎么强调也不为过。
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引用次数: 1
Mutations in GH1 gene and isolated growth hormone deficiency (IGHD): A familial case of IGHD type I and systematic review GH1基因突变和分离性生长激素缺乏症(IGHD): 1例家族性IGHD I型病例和系统综述
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101423
Qiuyue Li , Zhenran Xu , Miaoying Zhang , Zhuhui Zhao , Bijun Sun , Lin Yang , Wei Lu , Feihong Luo , Chengjun Sun

Background

Isolated growth hormone deficiency (IGHD) due to mutations in GH1 gene is a rare disease caused by deficient production of endogenous growth hormone (GH).

Methods

We reported the clinical manifestation and genetic diagnosis (whole exome sequencing [WES], nested PCR Sanger sequencing, and rtPCR) of a family with two children with IGHD type I. We conducted a systematic review of cases with IGHD and compared height, and treatment outcomes in subtypes of IGHD.

Results

The patients were siblings born of nonconsanguineous parents from the Chinese Han population. The siblings both presented significantly short stature without other apparent abnormalities. The patients carry compound heterozygous mutations in GH1: a deletion and c.456 + 1G > A mutation that led to abnormal splicing. The systematic review identified 365 IGHD cases with GH1 mutations. Among these patients, their body height was most severely impaired in patients with IGHD type Ia, and the height standard deviation score decreased with the age of diagnosis in IGHD type Ia. Patients with IGHD type II had the longest duration of rhGH treatment, while patients with IGHD type Ib had the highest relative height improvement.

Conclusion

We identified two patients with IGHD type I caused by compound heterozygotic GH1 deletion and splicing mutation. The analysis of previously published IGHD patients suggests differences in linear growth among subtypes of IGHD.

背景:由GH1基因突变引起的分离性生长激素缺乏症(IGHD)是一种由内源性生长激素(GH)产生不足引起的罕见疾病。方法报告1例有2例IGHD i型患儿家庭的临床表现和遗传诊断(全外显子组测序[WES]、巢式PCR Sanger测序和rtPCR)。对IGHD病例进行系统回顾,比较各亚型IGHD的身高和治疗结果。结果患者均为汉族非近亲所生的兄弟姐妹。兄弟姐妹都表现出明显的身材矮小,没有其他明显的异常。患者携带GH1的复合杂合突变:缺失和c.456 + 1G >一种导致异常剪接的突变。系统评价确定了365例GH1突变的IGHD病例。其中,Ia型IGHD患者身高受损最为严重,且身高标准差评分随诊断年龄的增加而降低。IGHD II型患者rhGH治疗持续时间最长,而IGHD Ib型患者相对身高改善幅度最大。结论本研究发现2例由复合杂合子GH1缺失和剪接突变引起的I型IGHD。对先前发表的IGHD患者的分析表明,IGHD亚型之间的线性生长存在差异。
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引用次数: 1
Course and outcomes of pregnancy in women treated for acromegaly: Discerning a contemporary cohort 肢端肥大症治疗妇女的妊娠过程和结局:辨别当代队列
IF 1.4 4区 医学 Q4 CELL BIOLOGY Pub Date : 2021-10-01 DOI: 10.1016/j.ghir.2021.101417
Liza Das , Pinaki Dutta , Balamurugan Thirunavukkarasu , Kirti Gupta , Manjul Tripathi , Prakamya Gupta , Neelam Aggarwal , Ashutosh Rai , Bishan Dass Radotra , Anil Bhansali , Vanita Suri

Objective

To analyze pregnancy course and outcomes in women treated for acromegaly and compare outcomes based on disease activity at the time of conception.

Design

Retrospective study.

Patients

Women with acromegaly diagnosed prior to or during pregnancy from 2010 to 2019, representing cases (14 pregnancies in 12 cases), were later stratified based on active (n = 5) or controlled disease (n = 9) at time of conception. Female acromegalic patients over the same period constituted the ‘acromegaly cohort’ (AC) (n = 75).

Results

All cases had macroadenomas with nadir GH of 15.06 ng/ml (IQR 9–30), IGF-I index of 3.04 (1.96–3.82), for which they had undergone pituitary surgery; except two patients diagnosed during pregnancy, who received pharmacotherapy followed by surgery 4 months postpartum. Adjuvant pharmacotherapy was required in 71.4% patients and radiotherapy in 35.7%. Pregnancy occurred at a median of 2 (0.8–5.1) years after surgery and 21.4% required assisted reproduction. All had term delivery with normal APGAR except one case with gestational hypertension, who delivered a preterm baby. None had congenital malformations. Despite higher baseline IGF-I, GH and tumor volume in those with pre-conceptional active acromegaly, materno-fetal outcomes were not different from those with controlled disease (p > 0.05). Similar or greater proportion of cases had normal GH and no residual tumor postpartum, even in those with pre-conceptional active acromegaly.

Conclusion

The current study showed conducive outcomes of gestation in women treated for acromegaly and no higher rates of pregnancy parameters or complications than non-acromegaly pregnancies in the same population. Active acromegaly does not seem to have an adverse bearing on outcomes.

目的分析肢端肥大症患者的妊娠过程和结局,并比较妊娠时疾病活动性的结局。DesignRetrospective研究。2010年至2019年妊娠前或妊娠期间诊断的肢端肥大症患者(12例中有14例妊娠),随后根据妊娠时的活跃性(n = 5)或控制疾病(n = 9)进行分层。同一时期的女性肢端肥大症患者构成“肢端肥大症队列”(AC) (n = 75)。结果所有大腺瘤患者均行垂体手术,最低GH为15.06 ng/ml (IQR 9-30), IGF-I指数为3.04 (1.96 ~ 3.82);除2例在妊娠期确诊外,均在产后4个月接受药物治疗后手术治疗。71.4%的患者需要辅助药物治疗,35.7%的患者需要放疗。手术后怀孕的中位数为2年(0.8-5.1年),21.4%需要辅助生殖。除1例妊娠期高血压患者早产外,其余均足月分娩,APGAR正常。没有先天性畸形。尽管孕前活动性肢端肥大症患者的基线IGF-I、GH和肿瘤体积较高,但母胎结局与疾病控制的患者没有差异(p >0.05)。类似或更大比例的病例生长激素正常,产后无残留肿瘤,甚至在那些孕前活动性肢端肥大症。结论本研究显示,肢端肥大症患者妊娠结局良好,妊娠参数和并发症发生率均不高于非肢端肥大症患者。活动性肢端肥大症似乎对预后没有不利影响。
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引用次数: 3
期刊
Growth Hormone & Igf Research
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