Comparison The Change Of Levels Of Serum IGF-1 And 25-(OH)D In Children With Growth Hormone Deficiency And Idiopathic Short Stature

Objective: Short stature is one of the most common diseases in pediatric endocrine clinic.There are many complex reasons for cause the slow growth of children's height,Which can be broadly divided into two categories what is growth hormone deficiency(GHD)and non growth hormone deficiency(n-GHD).In the latter type,idiopathic short stature(ISS)is most common.In this study,according to the latest diagnostic criteria of ISS and GHD,118 children were selected,at the same time.To detect the serum levels of IGF-1 and 25-(OH)D for all the selected subjects,and then to explore the differences of IGF-1 and 25-(OH)D levels in the body of the two different types of short stature children,and the differences of IGF-1 levels in different ages,in order to provide the basis for the diagnosis and treatment of the cause of short stature in children,it is used as a routine detection index in clinic.Methods:1 Selected subjects:collect 118 cases of 3-16 years old children who were treated in the Department of Pediatrics of the Third Hospital of Hebei Medical University from June 2014 to December 2015,among them,79 cases(66.9%)were male,39 were female(33.1%);the average age was(9.35±3.42)years.20 cases of normal height matched by age and sex were randomly selected from the healthy children as control group.Standard reference "short" reference "in 2005 China nine province/city children's physical development survey data research and development of 0-18 years old children's height,weight standard deviation unit numerical table".2 Division groups:118 children with short stature were divided into CHGD group,PGHD group and ISS group according to the peak value of growth hormone drug stimulation test.The groups were divided into 5 subgroups according to their age: 3.0-5.9 years old group,6.0-8.9 years old group,9.0-11.9 years old group,12.0-13.9 years old group and 14.0-16 years old group,which were used to compare the difference of IGF-1 level between different subgroups.3 Specimen collection: every child does not eat at night after beijing time 20 o'clock,Blood samples were taken at 6:00 from to 8:00 in the early morning,and the dose was 4m1,centrifugal separation of serum after static,in which meet the test requirements of qualified specimens would placed in the-80 low temperature freezer,for the detection of serum IGF-1,25-(OH)D levels.Comprehensive analysis of the height,weight,upper and lower volume and other basic physical examination data,as well as the hospital laboratory and imaging department issued a routine examination results,according to the appropriate diagnostic guidelines for the diagnosis of the cause of short stature.4 Experimental process: the experimental instrument is SIEMENS company production of IMMULITE 1000 automatic chemiluminescence immunoassay analyzer,human insulin growth factor-1(chemiluminescence)kit provided by American Depp Corporation(DPC),operate strictly according to the specification,measure the serum IGF-1 value.A liquid chromatography tandem mass spectrometry by the Beijing Hester clinical laboratory(LC-MS/MS)API 4000 detected serum 25-(OH)D.5 Statistical methods: Using SPSS19.0 version of statistical software for data analysis and statistical chart production.All data were tested for normal distribution and homogeneity of variance,Part of the data is converted into normal state,according to the test results,the results were compared between groups by ANOVA,nonparametric test and other statistical methods.Set the standard test level of a=0.05,if P<0.05,the difference was statistically significant,P<0.01 difference was statistically significant.Results:28 cases of idiopathic short stature(ISS)in 118 cases,accounting for 23.7%;growth hormone deficiency(GHD)in 90 cases,of which 51 cases of complete growth hormone deficiency(CGHD),accounting for 43.3%,part growth hormone deficiency(PGHD)in 39 cases,accounting for 33%.CGHD group,PGHD group,ISS group and normal group serum IGF-1and25-(OH)Dlevelswere:153.32±81.41ng/ml,170.00(107.00)ng/ml,202.50(188.25)ng/ml,448.21±149.73ng/ml;17.50(11.84)ng/ml,22.35±10.49ng/m l,21.72±11.96ng/ml,34.41±4.03ng/ml.Comparison of the measured data after the normal state transition,the serum levels of IGF-1 and 25-(OH)D in the first three groups were lower than those in the normal group(P<0.01;P<0.05);CGHD group and PGHD group,CGHD group and ISS group of serum IGF-1 were different(P<0.05);There was no difference in serum IGF-1 between the PGHD group and the ISS group(P>0.05).There was no difference in serum 25-(OH)D between the three groups of CGHD,PGHD and ISS(P>0.05).To compare the difference of IGF-1 level between different age groups:3.0-5.9 years old group,IGF-1 group CGHD lower than the PGHD group,the difference was statistically significant(P=0.036<0.05),and the level of ISS in the IGF-1 group and PGHD group,ISS and CGHD were no difference(P>0.05),the three groups of IGF-1 were lower than the normal group,the difference was statistically significant(P<0.01);6.0-8.9 years old group and 9.0-11.9 years old group had the same results,CGHD group IGF-1 was lower than PGHD,ISS two groups,the difference was statistically significant(P<0.05),three groups of IGF-1 were lower than the normal group,the difference was statistically significant(P<0.01),there was no difference between the IGF-1 levels in the ISS group and the PGHD group(P>0.05);12.0-13.9 years old group,CGHD,ISS and PGHD between the three groups were no difference(P>0.05),but all lower than the normal group,the difference was statistically significant(P<0.01);14.0-16 years old group,CGHD,ISS,PGHD,the normal group between the four groups were no difference(P>0.05).Conclusions:1 GHD and ISS are the most common causes of short stature.2 GHD,ISS in children with serum IGF-1 levels were lower than the normal children,especially in the GHD to reduce the more obvious.3 IGF-1 in different growth hormone secretion state in serum of children of concentration difference,suggesting that the effective as children with short stature etiology diagnosis of auxiliary index and in the diagnosis of GHD than ISS more clinical significance.4 Short stature children's serum 25-(OH)D level than the normal size of children,25-(OH)D in children with growth disorders in the development process has played a role,further research is needed in the specific mechanism.Recommended for children with short stature to supplement the conventional dose and time of vitamin D may be useful in long bone growth to improve a height at the end of the year.