Effect Of Recombinant Human Growth Hormone Therapy On Idiopathic Short Stature And Related Factors

Object: Idiopathic short stature(ISS)is the most common type of dwarfism children,etiology and pathogenesis is still unclear,subcutaneous injection of recombinant human growth hormone(rh GH)is the main method for the treatment of ISS,but its curative effect is affected by many factors.The study found that insulin-like-growth factor-1(IGF-1),growth hormone releasing peptide(Ghrelin)feed,antimicrobial peptides(Nesfatin-1)are involved in the growth process of the body,they are may closely related to the illness and treatment efficacy of the ISS.However,there have been few reports on this aspect of research.This study looked at the levels of serum IGF-1,Ghrelin and Nesfatin-1 in patients with ISS before and after rh GH treatment and their correlation with linear growth.To explore the changes of the endocrine factors in the patients with rh GH treatment of ISS.It aims to provide the basis for clinical diagnosis and treatment of children with ISS.Methods: Thrity-six ISS children diagnosed as pediatric patients in Children’s Health Clinic of Hebei Provincial People’s Hospital from 2016 to 2017 were selected as the observation group,including 21 boys and 15 girls.The average age was 3 to 7 years.At the same time,there were 20 healthy children(12 boys and 9 girls)who were randomly selected for the physical examination of our hospital.In All selected children,there was no significant difference in living environment,lifestyle,eating habits,etc.The group was treated with recombinant human growth hormone(rh GH).The serum IGF-1,Ghrelin and Nesfatin-1 levels were detected before treatment and in the third 、sixth months of the treatment of children with ISS.The serum IGF-1,Ghrelin and Nesfatin-1 levels were determined by the same method and reagent respectively in the Control group.To collect all the clinical data of children,and a detailed comprehensive physical examination,measurement of Height(Ht),Weight(Wt),calculate the Body Mass Index(BMI),Growth Velocity,(GV).The serum IGF-1 level was determined and provided data by immuno-chemiluminescence in our hospital Nuclear medicine department,the serum levels of Ghrelin and Nesfatin-1 using ELISA method to detect.SPSS21.0 statistical software package was used for data analysis.To compare the statistical significance of the differences between the children of ISS and the control group,including Ht,Wt,BMI,GV and serum biochemical indicators IGF-1,Ghrelin and Nesfatin-1.Changes and Correlations in the growth parameters(Ht,Wt,GV,BMI)and serum biochemical indicators(IGF-1,Ghrelin and Nesfatin-1)of the children in ISS before and after treatment.To observe the short-term curative effect of rh GH on children with ISS,and the relationship with serum IGF-1,Ghrelin and Nesfatin-1.P<0.05 was considered statistically significant.Results: 1 The Ht,GV and level of serum IGF-1 was significantly lower in the observation group than in the control group,and the level of serum Ghrelin was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Wt was slightly lower than the control group,and the difference was not statistically significant(P>0.05).BMI was slightly higher than the control group,and the difference was not statistically significant(P>0.05).The level of serum Nesfatin-1 was slightly higher than the control group,and the difference was not statistically significant(P >0.05).2 Compared with the before treatment,the Ht,Wt and GV in the observation group of ISS was significantly increased in 3 and 6 months after treatment,and the difference was statistically significant(P<0.05).The BMI decreased,and the difference was not statistically significant(P>0.05).The level of serum IGF-1 increased,and the difference was statistically significant(P<0.05).The level of serum Ghrelin was decreased,as the treatment time was prolonged,the decrease was more obvious,and the difference was statistically significant(P<0.05).The level of serum Nesfatin-1 decreased slightly,and the difference was not statistically significant(P>0.05).3 The △Ht and GV in children with ISS after 3-6 months treatment was higher than that in 0-3 months.The difference was statistically significant(P < 0.05)..4 Serum IGF-1 was positively correlated with Height in children with ISS(r=0.61,P<0.001);There was a negative correlation between serum Ghrelin level and height(r=-0.405,P=0.014),and a negative correlation with Weight(r=-0.498,P=0.002).The serum Nesfatin-1 was negatively correlated with Weight(r=-0.393,P=0.018).5 The GV3 at the time of treatment for 3 months was positively correlated with the level of serum IGF-1 before treatment(r=0.618,p<0.001).Conclusion: 1 Serum IGF-1,Ghrelin and Nesfatin-1 all play an important role in the growth and development of children.2 Serum IGF-1 and Ghrelin are closely related to the linear growth of ISS,high levels of Ghrelin in children with ISS suggest that Ghrelin resistance or some signal transduction mechanisms may be abnormal.3 Nesfatin-1 mainly regulates weight gain.4 Rh GH short-term treatment can effectively improve the height of children in ISS,while the exogenous GH elevation can be reduced by negative feedback to the level of Ghrelin.5 At the high level of serum IGF-1,rh GH has a more significant growth-promoting effect.