身材矮小男童血清胰岛素样生长因子1水平与生长关系的研究

Study on serum insulin-like growth factor-1 level and its relationship with growth in children with short stature

目的:对134例身材矮小男童进行病因分析,探讨血清胰岛素样生长因子1(IGF-1)水平与生长的关系。方法:选择安徽省第二人民医院2015年7月至2019年7月诊治的有矮小表现的4~15岁男童134例(矮小组)和同期无矮小及其他器质性疾病的4~15岁男童134例(对照组)为研究对象,进行清晨空腹血清IGF-1测定和生长激素(GH)激发试验,对不同类型、不同年龄段身材矮小男童的血清IGF-1与对照组进行对照分析。结果:矮小组中,特发性矮小(ISS)41例(30.6%),生长激素缺乏症(GHD)80例(59.7%),其他类型矮小13例(9.7%)。GH完全缺乏的身材矮小男童、GH部分缺乏的身材矮小男童、特发性矮小男童血清IGF-1分别为(172.71±86.49)ng/mL、(167.61±100.10)ng/mL、(170.33±99.77)ng/mL,均显著低于对照组的(365.33±96.42)ng/mL,差异均有统计学意义(t=-8.92、-13.96、-9.27,均P<0.01)。身材矮小男童IGF-1与身高呈低度相关(r=0.357,P<0.01),与体质量、GH无明显相关性。结论:就诊的矮小男童中以GHD为多见,其次为ISS,测定IGF-1水平可作为筛查和诊断身材矮小有价值的指标,但对于临床区别不同类型的矮小无意义。对矮小患儿应完善相应检查明确病因,给予对因治疗。

Objective:To analyze the etiology of 134 short stature children and to explore the relationship between serum insulin-like growth factor-1(IGF-1)level and growth.Methods:From July 2015 to July 2019,134 children aged 4-15 years with short stature(short group)and 134 children aged 4-15 years without short stature and other organic diseases(control group)who were diagnosed and treated in the Second People's Hospital of Anhui Province were selected in the research.The early morning fasting serum IGF-1 determination and growth hormone(GH)stimulation test were conducted.The serum IGF-1 of short stature children of different types and ages were compared with the control group.Results:In the short group,41 cases(30.6%)were idiopathic short stature(ISS),80 cases(59.7%)were growth hormone deficiency(GHD),and 13 cases(9.7%)were other types of short stature.The serum IGF-1 levels of short stature children with complete GH deficiency,short stature children with partial GH deficiency and ISS children were(172.71±86.49)ng/mL,(167.61±100.10)ng/mL,(170.33±99.77)ng/mL,respectively,which were significantly lower than those of the control group[(365.33±96.42)ng/mL],the differences were statistically significant(t=-8.92,-13.96,-9.27,all P<0.01).The IGF-1 in short stature children was low correlated with height(r=0.357,P<0.01),but had no significant correlation with body mass and GH.Conclusion:GHD is the most common type of short stature children in Anhui province,followed by ISS.Determination of IGF-1 level can be used as a valuable indicator for screening and diagnosing short stature,but it is not meaningful for clinical differentiation of different types of short stature.For children with short stature,corresponding examination should be perfected to determine the cause,and treatment should be given due to the cause.