Study On The Change Of The Levels Of Serum 25-(OH)D And IGF-1 In Short Stature Children

Objective Short stature is the most common diseases in pediatric endocrine in China,with various and complex causes.It can be divided into growth hormone deficiency(GHD)and idiopathic shortness(ISS).The purpose of this study is to set up the basic theory for the diagnosis and treatment of short stature by observing the different levels of serum 25-(OH)D and serum IGF-1 in children with short stature.Methods 123 children were retrospectively analysis,who were diagnosed with short stature children in the pediatric endocrinologist clinic of the First People’s Hospital of Changde City from March 2018 to June 2019,and randomly selected 28 cases matched as control group,who check up health in our child health division during the same period.Group: 1.According to etiology,they were divided into GHD group(68 cases)and ISS group(55 cases).2.According to age,they were divided into 3.0 ～6.0 group(excluding 6 years old),6.0 ～ 9 group(excluding 9 years old),9.0 ～ 12 group(excluding 12 years old),and 12.0 ～ 14.0 group.General data,height(Ht),weight(Wt),body mass index(BMI),mid-parental height(MPH),the birth situation,medical history,serum 25-(OH)D,serum IGF-1,phosphorus(P),calcium(Ca),alkaline phosphatase(ALP)and other related indicators is collected.The levels of serum 25-(OH)D and IGF-1 in GHD group,ISS group and normal control group were compared,and to investigate the correlation between serum 25-(OH)D and IGF-1 and various clinical indicators.Results 1.Comparison of children clinical characteristics in GHD group,ISS group and normal control group: the difference in height and body weight of children in GHD group and ISS group were compared with those of normal control group respectively was statistically significant(P<0.05).2.Comparison of Serum ALP,P,Ca levels among three groups: The serum P level in the control group was lower than that in the ISS group and the normal control group(P=0.000);Comparing serum ALP and Ca level among three group respectively,which was no statistically significant.3.Comparison of serum 25-(OH)D level and serum IGF-1 level among three group: serum 25-(OH)D in GHD group was lower than that in ISS group and control group with statistical significance(P=0.000).The serum IGF-1 in GHD group and ISS group was lower than that in normal control group(P=0.000).4.GHD group,ISS group and control group of serum vitamin D nutrition distribution comparison: the incidence of vitamin D deficiency and lack in GHD group were higher than in ISS group and normal control group;control group in proportion to the adequate vitamin D levels were higher than the ISS group and GHD group(H=28.534,P=0.000),control group > ISS > GHD group.5.Comparison of vitamin D nutritional status distribution of different genders in GHD group and ISS group: no difference in vitamin D nutritional status between GHD group and ISS group in gender(P>0.05).6.Comparison of different age stage of serum 25-(OH)D level in GHD group,the ISS group and control group:(3.0-6.0 years old,including 6 years old): Serum 25(OH)D level of ISS group compared with the control group and the GHD group respectively,which was higher than that of the two groups(P=0.034);GHD group and control group of serum 25-(OH)D level no statistically significant difference(P>0.05);(6.0-9.0 years old group,excluding 9 years old): Serum 25-(OH)D level of GHD group compared with the control group and the ISS group respectively,which was lower than that of the two groups(P=0.003).There was no difference in Serum 25(OH)D level,between ISS group and control group was statistically significant(P>0.05);(9.0 to 12.0 years old group,do not contain 12 years of age): At the level of 25-(OH)D,the ISS group and GHD group are lower than the normal group(P=0.000);(12.0-14.0 years old group): Serum 25-(OH)D level among the three groups was no difference in statistical(P>0.05).7.Different ages stage of three group in the levels of serum IGF-1 comparison:(3.0-6.0 years old,including 6 years old): Serum IGF-1 level of the control group is higher than GHD group and the ISS group(P=0.010).(6.0-9.0 years old group,excluding 9 years old): the serum IGF-1 level of the control group was higher than that of the GHD group and the ISS group,the difference was statistically significant(P=0.005).(9.0-12 years old group,excluding 12 years old): There was no statistically significant difference in serum IGF-1 level among the three groups(P>0.05).(12.0-14.0 years old group): the serum IGF-1 level of GHD group was lower than that of ISS group and control group,the difference was statistically significant(P=0.015).There was no statistical significance in serum IGF-1 level between ISS group and control group(P>0.05).The level of serum IGF-1 gradually increased with age.8.Serum 25-(OH)D,IGF-1 and clinical index of correlation analysis: short stature is positively correlated with GH peak(correlation coefficient r=0.249,P=0.006).Serum IGF-1 level was positively correlated with age,sex,BMI,bone age(correlation coefficient r=0.548,P=0.000;r=0.233,P=0.009;r=0.223,P=0.013;r=0.641,P=0.000),and negatively correlated with FT4(correlation coefficient r=-0.332,P=0.000).9.Multiple regression analysis showed that bone age and gender have an impact on the level of IGF-1 in short stature children(P=0.000;P=0.000).Conclusion 1.The level of serum 25-(OH)D in GHD and ISS children is significantly lower than that in normal children,and the decrease of GHD is the most significant,which indicating that vitamin D is the basis of bone growth.Therefore,attention should be paid to vitamin D supplement and monitoring in short stature children.2.The level of serum IGF-1 in short stature group was significantly lower than that in normal control group,which suggesting that IGF-1 may be involved in and mediate endogenous growth mechanism,it as an important monitoring index in the diagnosis and treatment of short stature.3.The level of serum IGF-1 in short stature children is different at different ages,and the level of serum IGF-1 gradually increases with age.4.There is a positive linear relationship between GH peak and 25-(OH)D in short stature children.Gender and bone age are important factors for IGF-1 levels.