Analyzing The Etiology Of Short Stature Children And Establishing The Diagnosis Prediction Model Of Growth Hormone Deficiency Using Serum IGF-1Levels

Objective: Recent years, short stature has become one of the mostcommon diseases in pediatric endocrine clinic. To make short stature childrenachieve the ideal final high, early identify the etiology and correct the adversefactors that affect children’s growth and development is helpful. This studywill analyze causes of short stature children, explore the relationship betweenserum GH and IGF-1levels. GHD diagnosis prediction model is establishedfor research by serum IGF-1levels. In clinical, it can provides the theory basisfor rapid screening and diagnosis of short stature children in outpatient.Methods:1Test object: choose132cases of short stature children inpediatric clinic of the third hospital of hebei medical university in March2012-September2013. The standard Height/Weight Deviation Units Form(Age.0-18) which based on physical development survey data in9provinces/cities in the year2005as the parameters of height standard. Shortstature diagnostic criteria in accordance with the Chinese medical associationacademy of pediatrics genetic metabolic endocrine group 《The diagnosis andtreatment guide of short stature children》, living in similar circumstances,namely individual height is lower than the same race, gender and age of thegeneral population average height2standard deviation, or below the thirdpercentile specimen;2specimen collection: each of them were fasting10-14hat night, blood sampling4ml at dawn6:00. After standing and centrifugation,put these serum on-80℃low temperature refrigerator for the detection ofserum IGF-1,25-hydroxy serum vitamin D [25-(OH)D] levels. Combinedphysical examination and laboratory test results to make a diagnosis for thecauses of short stature;3experimental process: use SIEMENS IMMULITE1000Automated Chemiluminescence Immunoassay Analyzer, which is the production of Germany. Depp companies in the United States (DPC) providesthe human insulin growth factor-1(chemiluminescence method) kits, thenmeasured serum IGF-1values in strict accordance with the specifications.Serum25-(OH)D values are obtained by Jin Yu inspection center using highperformance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS) API4000;4Statistical analysis was performed using SPSS18.0statistical software. All data should make homogeneity of variance andnormal distribution tests. Normal distribution measurement data werepresented as mean±standard deviation (x±ｓ).Difference between twogroups was analyzed by independent-sample T test. Non-normal distributionmeasurement data were presented as the median and interquartile range.Difference between two groups was analyzed by using rank-sum test. Aprediction model of GHD was established by Logistic stepwise multivariateregression based on serum IGF-1level.Setting α=0.05, there was statisticalsignificance if P<0.05for the difference.Results: The etiology of short stature is complex and diverse. Endocrinediseases account for the first place, the GHD is one of the most common cause.In132cases of short stature children,67cases (46.97%) were diagnosed asidiopathic GHD,42cases (31.82%) were idiopathic short stature (ISS),6cases(4.54%) were constitutional delay of growth and puberty,3cases (2.27%)were familial short stature. The rests were attributed to other reasons，such ashypothyroidism，small for gestational age,intrauterine growth retardation,Turner syndrome, skeleton deformity and so on. There existed significantlystatistical difference(P<0.05) in age, weight, height, ALT, AST, ALKP, IGF-1and25-(OH)D levels between GHD and non-GHD groups. If the probabilityof GHD is P, the Logistic stepwise multivariate regression regression equationis as follows: LN[P/(1-P)]=―1.461+0.654×age―0.095×AST―0.012×ALKP－0.025×IGF-1.Conclusion:1.The etiology of short stature children are complicated,endocrine disease still place in No.1on which we can considered, especiallythe highest incidence of GHD.2.Diagnose GHD need comprehensive consideration, according to the serum IGF-1fitting GHD diagnosis model ismore accurate predictive value, is conducive to quick out-patient screening.3.Further research needs to find the etiology of short stature and a simple andeffective method for the diagnosis of GHD.