The Changes Of Serum IGF-1, IGFBP-3 And The Pituitary Magnetic Resonance Imaging Study In Children With Short Stature

Objective To observe the changes of the serum IGF-1,IGFBP-3 in children with growth hormone deficiency (GHD), non-GH deficient short stature (ISS) and GHD after 3, 6 months of r-hGH treatment and evaluate the pituitary MR images of 18 GHD and 12 ISS patients, and explore their clinical significance.Materials and Methods Serum IGF-1, IGFBP-3 levels were measured in 45 GHD children before and after 3, 6 months of r-hGH therapy, and compared to 35 ISS children and 20 normal children. The serum IGF-1 and IGFBP-3 levels were measured by ELISA. The pituitary MR imaging was examined in 18 cases of GHD children and 12 cases of ISS children. All calculation were performed with SPSS10.0.Results The serum levels of IGF-1 and lGFBP-3 were lower in GHD than those in ISS and control group (t=2.60, P<0.05; t=5.97, P<0.01, respectively). The serum levels of IGF-1, IGFBP-3 in ISS group were lower than those in control group (t=4.68, P<0.01). The sensitivity of IGF-1 in GHD was 100%, the specificity was 80%, the accuracy of test was 77.5%. The sensitivity of IGFBP-3 in GHD was 77.5%, the specificity was 62.5%, the accuracy of test was 65%. The sensitivity of IGF-1 and IGFBP-3 measured simultaneously in GHD were 77.5%, the specificity were 60%, the accuracy of test were 62.5%. The serum levels of IGF-1 and IGFBP-3 increased in GHD after 3, 6 months of r-hGH therapy. The MR imaging studies showed pituitary abnormalities were more common in GHD group (61%) than in ISS group (33%) (t=14.32, P<0.01). The pituitary abnormalities included small anterior pituitary and shifting of pituitary stalk. Auxological characteristics were different between the GHD patients with abnormal pituitary MR1 findings and those with normal findings. Chronological age, bone age, and height SDS at evaluation were lower in GHD with abnormal pituitary MR1. Conclusion 1) The serum level of IGF-1 and IGFBP-3 are lower in GHD and in ISS patients than normal, especially in GHD. Being detected together are more accurate than being detected respectively. 2) Pituitary MR1 can help clinical diagnosis of short stature patients and the evaluation of the anatomical defect of the pituitary. MR abnormalities were common in children with GHD. Chronological age, bone age, and height SDS were lower in GHD patients with abnormal pituitary MR1.