Insulin Growth Factor-1 in Egyptian Children with Juvenile Idiopathic Arthritis: Correlation with Growth Pattern and Disease Activity

Abstract

Background: Juvenile idiopathic arthritis (JIA) is a systemic, chronic, inflammatory disease that affects patients under 18 years. Interactions between growth hormone (GH), insulin-like growth factor-1 (IGF-1), and the immune system are complex. Many studies found that chronic inflammation suppresses GH/IGF-1 axis. Objective: To assess if there is correlation between the serum level of IGF-1 and the growth pattern in children with JIA in Egypt, and to evaluate the correlation between the serum level of IGF-1 and disease activity among these patients. Patients and Method: The study was a case control study which included 80 patients with JIA and 40 normal children as a control. Their ages ranged from 5-15 years. All patients were subjected to full history taking from their care givers, clinical examination, growth assessment, and laboratory measurement of serum IGF-1 level, CRP, ESR, and CBC. Results: There was a statistically significant decrease in serum level of IGF-1 among patients with JIA. There was a statistically significant positive correlation between serum level of IGF-1 with height, weight and BMI. There was a statistically significant difference between patients and controls regarding Height-for-Age-Z-Score (HAZ), 35% of patients had short stature. There was a statistically significant decrease in weight and BMI, 90% of patients were underweight. There was no statistically significant correlation between serum level of IGF-1 and the disease activity. Conclusion: There was a statistically significant positive correlation between IGF-1 with height, weight and BMI. Short stature and underweight were common among JIA patients. There was no significant correlation between serum level of IGF-1 and the disease activity among JIA patients.