特发性矮小症患儿血清IGF-1、皮质醇、hGH变化及其临床意义

Changes and clinical significances of serum IGF-1,cortisol,and hGH in children with idiopathic short stature

目的探讨特发性矮小症患儿血清胰岛素样生长因子-1(IGF-1)、血清皮质醇、生长激素(hGH)水平及其临床意义,旨在为特发性矮小症的早期诊治提供参考。方法回顾性分析2017年8月至2019年8月丽水市中心医院收治的75例特发性矮小症患儿(疾病组)和同期体检的75名健康儿童(健康组)资料,检测两组研究对象体格发育情况、血清IGF-1、皮质醇、hGH、营养元素水平,分析特发性矮小症患儿血清IGF-1、皮质醇、hGH、营养元素表达水平与体格发育指标相关性。结果疾病组身高、体重、体质量指数(BMI)显著低于健康组,差异有统计学意义(t值分别为7.333、17.565、6.703,均P<0.05);与健康组比较,疾病组血清皮质醇表达水平较高,IGF-1、hGH表达水平较低(t值分别为3.699、21.123、30.397,均P<0.05);营养元素(Ca、Mg、Cu、Fe、Zn)较健康组略低,但差异无统计学意义(均P>0.05);Pearson相关性分析提示,特发性矮小症患儿血清皮质醇表达水平与身高、体重、BMI呈明显负相关(r值分别为-0.686、-0.605、-0.594,均P<0.05),而IGF-1、hGH与身高、体重、BMI均呈明显正相关(r值分别为0.599、0.679、0.564、0.632、0.583、0.579,均P<0.05)。结论特发性矮小症患儿血清皮质醇水平明显上调而IGF-1、hGH水平明显下降,特发性矮小症患儿体格发育与皮质醇、IGF-1、hGH表达水平密切相关,临床严密监测儿童血清皮质醇、IGF-1、hGH表达水平,或可为特发性矮小症早期诊断及合理治疗方案的制定提供参考。

Objective To explore the levels and clinical significance of serum insulin-like growth factor-1(IGF-1),serum cortisol,and human growth hormone(hGH)in children with idiopathic short stature,so as to provide references for early diagnosis and treatment of idiopathic short stature.Methods The study retrospectively analyzed data of 75 children with idiopathic short stature(disease group)who treated in Lishui Central Hospital from August 2017 to August 2019,and 75 healthy children(healthy group)examined in the same period.Physical development,serum IGF-1,cortisol,hGH and trace elements levels in both groups were detected.And the correlations between serum IGF-1,cortisol,hGH and nutrient elements levels and physical development indexes in children with idiopathic short stature were analyzed.Results The disease group had significantly smaller height,weight and body mass index(BMI)than the healthy group(t values were 7.333,17.565 and 6.703,respectively,all P<0.05).Compared with the healthy group,the disease group had significantly higher level of serum cortisol,and significantly lower levels of IGF-1 and hGH(t values were 21.123,3.699 and 30.397,respectively,all P<0.05).Besides,the levels of nutrient elements(Ca,Mg,Cu,Fe,Zn)in the disease group were all slightly lower than those in the healthy group,but the differences were not significant(all P>0.05).Pearson correlation analysis showed that serum cortisol levels in children with idiopathic short stature were significantly negatively correlated with their height,weight,and BMI(r values were-0.686,-0.605 and-0.594,respectively,all P<0.05),while IGF-1 and hGH were significantly positively correlated with height,weight,and BMI(r values were 0.599,0.679,0.564,0.632,0.583 and 0.579,respectively,all P<0.05).Conclusion Children with idiopathic short stature have significantly elevated serum cortisol levels and decreased levels of IGF-1 and hGH.The physical development of children with idiopathic short stature is closely related to the levels of serum cortisol,IGF-1 and hGH.Clinically,closely monitoring levels of serum cortisol,IGF-1 and hGH in the clinical may provide references for the early diagnosis and treatment of idiopathic short stature.