特发性矮身材治疗前后血清Ghrelin、IGF-1及骨代谢标志物的变化及意义

Changes and Significance of Serum Ghrelin, IGF-1 and Bone Metabolism Markers before and after Treatment of Children with Idiopathic Short Statue

目的:探讨特发性矮身材(idiopathic short statue,ISS)儿童治疗前后血清Ghrelin、类胰岛素样生长因子-1(insulin-like growth factor,IGF-1)、骨代谢标志物的变化及意义。方法:回顾性分析2018年1—12月南昌大学第二附属医院儿科收治的40例ISS儿童的临床资料,所有纳入研究的ISS儿童每晚睡前注射重组人生长激素,同时选取在本院儿科门诊体检年龄、性别相匹配的40例正常儿童作为对照组。监测体格发育指标与血清Ghrelin、骨代谢标志物及IGF-1水平,计算身高标准差积分(height standard deviation score,HtSDS),然后将治疗前及治疗3个月、6个月的上述观察指标进行比较。结果:ISS组治疗后身高、体重、体重指数、骨龄(bone age,BA)较治疗前升高,但差异无统计学意义(P>0.05);ISS组治疗后HtSDS较治疗前改善,骨碱性磷酸酶(bone alkaline phosphatase,BAP)、骨钙素(osteocalcin,OC)及IGF-1均较治疗前升高,Ghrelin较治疗前降低,差异有统计学意义(P<0.05)。相关性分析显示,Ghrelin与IGF-1、身高、体重、HtSDS、OC呈负相关(P<0.05);IGF-1与身高、HtSDS、BA、OC呈正相关(P<0.05)。结论:Ghrelin及OC可作为ISS儿童疗效监测与评估的指标。

Objective:To investigate the changes and significance of serum Ghrelin,insulin-like growth factor(IGF-1)and bone metabolism markers before and after treatment of children with idiopathic short statue(ISS).Method:The clinical data of 40 children with ISS who admitted to the Department of Pediatrics,the Second Affiliated Hospital of Nanchang University from January to December 2018 were retrospectively analyzed.All children with ISS included in the study were injected with Recombinant Human Growth Hormone before sleep every night.At the same time,40 normal children with matched age and gender were selected as the control group in the Pediatric Outpatient Department of our hospital.Physical development indicators,serum Ghrelin,bone metabolism markers and IGF-1 levels were monitored,and height standard deviation score(HtSDS)were calculated.The above observation indicators were compared before treatment,3 months and 6 months after treatment.Result:The height,weight,body mass index and bone age(BA)of ISS group after treatment were higher than those before treatment,but the differences were not statistically significant(P>0.05),HtSDS of ISS group after treatment were significantly improved compared with that before treatment,the levels of bone alkaline phosphatase(BAP),osteocalcin(OC)and IGF-1 were significantly higher than those before treatment,Ghrelin was lower than that before treatment,and the differences were statistically significant(P<0.05).Correlation analysis showed that Ghrelin were negatively correlated with IGF-1,height,weight,HtSDS and OC(P<0.05);IGF-1 were positively correlated with height,HtSDS,BA and OC(P<0.05).Conclusion:Ghrelin and OC can be used as indicators to monitor and evaluate the efficacy of treatment in children with ISS.