Effect of serum IGF-1, IGFBP-3 and HtSDS in rhGH-treated SGA children

Abstract

Objective To investigate the clinical value of serum insulin-like growth factor-1 (IGF-1),insulin-like growth factor-binding protein-3 (IGFBP-3) and mean height standard deviation score(HtSDS) in recombinant human growth hormone (rhGH)-treated small for gestational age (SGA) children.Methods 32 cases of SGA failed of catch-up growth were subcutaneously injected with rhGH every night before bed at a dose of 0.15-0.20u· kg-1 · d-1.And the variation of serum IGF-1,IGFBP-3,HtSDS,body height and growth velocity (GV) were monitored at 3,6,9 and 12 months of the treatment and compared.Results The GV (cm/years) increased to (12.4 ± 3.2),(11.0 ± 2.3),(10.1 ± 3.5),(9.4 ± 1.8) versus (4.1 ± 0.5) before treatment,suggesting a significant catch-up growth after treatment (F =51.35,P ＜ 0.01).Accordingly,HtSDS increased to (-2.55 ± 0.73),(-2.39 ± 0.65),(-2.21 ± 0.58),(-2.09 ± 0.94) versus (-2.81 ± 0.64),suggesting that height gaps were reduced compared to the normal children of the same age and sex after rhGH treatment (F =4.99,P ＜0.01).The serum levels of IGF-1,IGFBP-3 were significantly increased compared to pre-treatment (F =34.52,14.04,all P ＜ 0.01),especially for serum IGF-1,which maintained at a high level after 3 months of treatment and up to peak after 6 months.However,the ratio of IGF-1/IGFBP-3 showed no increase after treatment (F =1.82,P ＞ 0.05).There was a significant positive correlation between the serum level of IGF-1 and △HtSDS after the rhGH treatment within six months (r3 =0.72,r6 =0.91),while there was no correlation between them after 9 months (r9 =0.26,r12 =0.33).There were no serious adverse events during the rhGH treatment.Conelusion The serum levels of IGF-1,IGFBP-3 were significantly increased after the rhGH treatment,especially for serum IGF-1.There was a significant positive correlation between the serum level of IGF-1 and △HtSDS within six months,but not after 9 months.The rhGH treatment could be a safe and effective strategy for SGA children. Key words: Growth hormone; Infant,low birth weight; Insulin-like growth factor-Ⅰ ; Insulin-like growth factorbinding protein3 ; Body height