Serum Bile Acid Levels And Correlation Analysis In Short Children With Recombinant Human Growth Hormone Therapy

Objective: To observe the changes of serum total bile acid(TBA)levels before and after recombinant human growth hormone(rh GH)treatment in children with short stature,and to preliminarily investigate the effect of 12 months of rh GH treatment on serum total bile acid levels and its correlation with other growth indicators were discussed.Methods: 52 patients with short stature who received rh GH treatment were selected as subjects,including 33 patients with growth hormone deficiency(GHD)and 19 patients with idiopathic short stature(ISS).Rh GH was injected subcutaneously before sleep with a therapeutic dose of 0.095-0.183 IU/(kg.d).Various growth parameters were recorded before and 1 year after treatment,including height(Ht),weight(Wt),body mass index(BMI),standard deviation score of height(Ht SDS),and growth rate of height(GV).And serum total bile acid,insulin-like growth factor-1(IGF-1),fasting blood glucose(FBG),glycosylated hemoglobin(HBA1c),fasting insulin(FINS)and serum triiodothyronine Indicators such as tyrosine(TT3),thyroid hormone(TT4),thyroid stimulating hormone(TSH)levels,uric acid and creatinine levels were measured before and 12 months after treatment.The changes of the above indexes and serum total bile acid(TBA)level before and after treatment were compared,and the correlation between serum total bile acid and growth parameters and serological indexes was analyzedResults: 1.Comparison of general characteristics,growth parameters and serological indicators of patients before rh GH treatment Fifty-two patients with short stature(31 males and 21 females),aged from 3.6 to 15.0 years old,including 33 patients with GHD and 19 patients with ISS,were enrolled.The rh GH dose was 0.095-0.183 IU/(kg.d).Before treatment,the △P3 in GHD group patients was significantly lower than those in ISS group(P =0.035),and the difference was statistically significant.rh GH dose in ISS group was significantly higher than that in GHD group(P =0.021),and the difference was statistically significant.There were no significant differences in Ht,Wt,BMI,Ht SDS between GHD group and ISS group before treatment(P<0.05),there was no statistically significant difference in serum IGF1,TT3,TT4,TSH,FBG,FINS,Hb A1 c,uric acid,creatinine,blood lipid and total bile acid levels between GHD group and ISS group before treatment(P>0.05).2.Comparison of growth parameters of patients before and after rh GH treatment After 12 months of rh GH treatment,Ht,Wt and Ht SDS in 52 patients were significantly higher than before treatment(P<0.05),but there was no significant change in BMI(P>0.05);According to the etiological grouping(GHD group and ISS group),the growth parameters Ht,Wt and Ht SDS of GHD and ISS groups after treatment were higher than those before treatment(P<0.05),BMI had no significant change compared with that before treatment(P>0.05).3.Serological index comparison of patients after rh GH treatment After 12 months of rh GH treatment,the serum IGF-1 level was higher than that before treatment(P=0.000).Serum IGF-1 level in GHD group and ISS group after treatment was higher than that before treatment,P=0.000.There was no significant difference in IGF-1 level between GHD and ISS groups after treatment(P>0.05).After 12 months of rh GH treatment,the FBG level was higher than that before treatment,P=0.031.The level of FBG in GHD group after treatment was higher than that in the group before treatment(P=0.029),But FBG level were within the normal range.There was no significant difference between before and after treatment in the ISS group(P>0.05);There was no statistically difference between GHD group and ISS group after treatment(P>0.05).There were no statistically significant differences in FINS and Hb A1 c between before and after 12 months of rh GH treatment,no statistically significant differences between GHD and ISS group after 12 months of rh GH treatment(P>0.05).Serum TT3,TT4,TSH,uric acid and creatinine levels were not statistically significant between before and after 12 months of rh GH treatment,no statistically significant differences between GHD and ISS group after 12 months of rh GH treatment(P>0.05).4.Changes in blood lipid and serum total bile acid levels before and after rh GH treatment Serum levels of TC,TG,LDL-c and HDL-c were not statistically significant between before and after 12 months of rh GH treatment,no statistically significant differences between GHD and ISS group after 12 months of rh GH treatment(P>0.05).After 12 months of rh GH treatment,the serum total bile acid level of the patients was lower than that before treatment(P = 0.018).The total bile acids level of GHD group decreased after treatment compared with that before treatment,P=0.011,and there was no statistically significant difference before and after treatment in ISS group(P>0.05);There was no significant difference between GHD group and ISS group after 12 months of treatment(P>0.05).5.Correlation analysis of serum total bile acid and growth parameters before and after rh GH treatment There was no correlation between serum total bile acid level and Ht,Wt,BMI,Ht SDS,GV and dose before rh GH treatment.rh GH was positively correlated with △HTSDS after 12 months of treatment(the correlation coefficient r=-0.054,P=0.018),and was not correlated with other indicators.6.Correlation analysis of serum total bile acid and serological indicators before and after rh GH treatment There was no correlation between serum total bile acid level and IGF-1,TT3,TT4,TSH,FBG,FINS,HBA1 c,uric acid,creatinine and blood lipid before rh GH treatment.After 12 months of rh GH treatment,the serum total bile acids level was positively correlated with TC(the correlation coefficient r=0.761,P=0.031),and was not correlated with other indicators.Conclusion: 1.The height of patients with GHD and ISS after 12 months of rh GH treatment was significantly improved,and there was no significant effect on blood glucose,insulin,lipid,and thyroid function.2.After 12 months of rh GH treatment,serum bile acid level was significantly reduced and positively correlated with △HTSDS and TC.3.The treatment of GHD and ISS patients with rh GH may affect the metabolism of bile acids in the body.