Abstract
BackgroundThe growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children’s growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS.MethodsA cross-sectional analysis was performed including 178 children and adolescents with ISS who were enrolled from March 2013 to February 2019. The related clinical and biochemical parameters were evaluated for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were performed.ResultThe mean levels of IGF-1 standard deviation scores (SDS) and Hb were − 0.99 (− 1.60 - -0.09) and 131.81 ± 9.36 g/L, respectively. Univariate analysis displayed a significant positive association between Hb and IGF-1 SDS (P < 0.001). After adjusting for potential confounding factors, the positive relationship between Hb and IGF-1 SDS remained (P = 0.001). Furthermore, there was an inflection point for Hb in the curve. In a multivariate piecewise linear regression model, IGF-1 SDS was significantly positively associated with Hb when Hb concentrations were lower than 145 g/L (B 0.05; 95% CI 0.02, 0.07; P < 0.001). However, IGF-1 SDS decreased with increasing Hb levels when Hb concentrations were greater than 145 g/L (B -0.15; 95% CI -0.23, − 0.06; P = 0.001).ConclusionThis study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with ISS. The levels of IGF-1 increased with the elevation of Hb, but when the concentration of Hb exceeded a certain range, with the increase of Hb, IGF-1 decreased instead.
Highlights
The growth hormone/insulin-like growth factor-1 (GH/Insulin-like growth factor-1 (IGF-1)) axis is critical for the regulation of children’s growth and development
This study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with idiopathic short stature (ISS)
We previously reported that uric acid (UA) and low-density lipoprotein cholesterol (LDLC) are associated with IGF-1 [6, 7]
Summary
The growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children’s growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS. We explored the association of hemoglobin (Hb) levels with IGF-1. Many studies have demonstrated that Hb is significantly associated with the linear growth of children [8]. Soliman et al pointed out the possible relationship between low concentrations of Hb and impaired IGF-1 [12]. Potential mechanisms include oxidative stress, increased blood viscosity, and impaired systemic response to inflammation and infection [13,14,15], which might negatively impact the linear growth of children [16]. No study has focused on investigating the relationship between high Hb concentrations and growth indicators
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