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Abstract
BackgroundElevated low-density lipoprotein cholesterol (LDL-C) levels in childhood have recently been found to be the strongest predictive risk factor for coronary artery disease in adulthood. There is an increased level of LDL-C in children and adolescents with short stature. However, the underlying factors associated with increased LDL-C levels in children and adolescents with short stature are unknown. In addition, the insulin-like growth factor 1 (IGF-1) level in the short-stature population is usually below the normal reference range. The aim of this study was to investigate the relationship between IGF-1 standard deviation score (IGF-1 SDS) and LDL-C level in children and adolescents with short stature.MethodsA cross-sectional study was conducted in a single centre of China, 557 short-stature children and adolescents whose height SDS was lower than − 2 SD after adjustment for age and gender were included. The related clinical and laboratory examinations, including anthropometric parameters, lipid profiles, IGF-1 levels and the levels of other cofactors, were assessed in all participants.ResultsThe univariate analysis results showed a significant negative correlation between IGF-1 SDS and LDL-C levels (P = 0.006). Furthermore, a nonlinear relationship was observed between IGF-1 SDS and LDL-C by smooth curve fitting after adjusting for possible confounders. A multivariate piecewise linear regression model revealed a significant negative correlation between IGF-1 SDS and LDL-C when the IGF-1 level was greater than − 2 SDS (β − 0.07, 95% CI -0.12, − 0.02; P = 0.006). However, we did not observe a significant relationship between IGF-1 SDS and LDL-C when the IGF-1 level was lower than − 2 SDS (β 0.08, 95% CI -0.02, 0.17; P = 0.119).ConclusionThis study demonstrated a nonlinear relationship between IGF-1 and LDL-C independent of other potential confounding factors, suggesting that circulating IGF-1 may contribute to the regulation of LDL-C levels, thus meriting further investigation.
Highlights
Dyslipidaemia in childhood and adolescence is a strong marker of atherogenic risk and may contribute to the development of coronary heart disease (CHD) in adulthood [1, 2]
Some studies have provided evidence that short stature is a risk factor associated with CHD [8, 9] and non-high-density lipoprotein cholesterol levels even after adjustment for body mass index (BMI) in adults [10], and recent studies have reported that an inverse relationship between height and non-HDL cholesterol is exists in children [11,12,13]
Other variables that remained significantly associated with low-density lipoprotein cholesterol (LDL-C) were age, weight, BMI standard deviation scores (SDS), TG, Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C) and pubertal stage (P < 0.05)
Summary
Dyslipidaemia in childhood and adolescence is a strong marker of atherogenic risk and may contribute to the development of coronary heart disease (CHD) in adulthood [1, 2]. Some studies have provided evidence that short stature is a risk factor associated with CHD [8, 9] and non-high-density lipoprotein (non-HDL) cholesterol levels even after adjustment for body mass index (BMI) in adults [10], and recent studies have reported that an inverse relationship between height and non-HDL cholesterol is exists in children [11,12,13]. These studies suggest the need to analyse the lipid profiles and the associated factors, especially in children and adolescents with short stature. The aim of this study was to investigate the relationship between IGF-1 standard deviation score (IGF-1 SDS) and LDL-C level in children and adolescents with short stature
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