儿童矮小症血液电解质及微量元素与体格发育

本文分析了矮小症儿童的生长发育与血液电解质及微量元素间的关系,阐述了儿童矮小症类型、血液电解质微量元素间的关系、锌、钙、镁等不同血液电解质与体格发育的关系,并且提出缺乏微量元素的预防方案,以期为临床治疗提供参考。     

HMGA2基因多态性、血清IGF-1对特发性矮小症rhGH疗效影响的交互作用分析

目的 探究高迁移率蛋白A2(HMGA2)基因多态性、血清胰岛素样生长因子-1(IGF-1)对特发性矮小症(ISS)重组人生长激素(rhGH)疗效影响的交互作用。方法 选取2020年2月至2021年8月本院收治的ISS患儿100例,选取同期于本院接受体检的健康儿童100例纳入对照组,PCR测序分析HMGA2基因多态性情况,所有患儿均予以指导接受rhCH治疗;分析对照组和研究组HMGA2基因多态性分布和血清IGF-1表达;分析不同基因型患儿GH治疗前后IGF-1变化;分析HMGA2基因多态性联合IGF-1对ISS患儿rhGH疗效预测价值。对比不同HMGA2基因多态性ISS患儿rhGH生长情况和IGF-差异;分析不同HMGA2基因多态性和IGF-1、疗效的相关性。结果 对照组和研究组儿童在HMGA2基因SNP rs1042725和SNP rs7968682分布差异显著,主要表现为在基因SNP rs1042725中,对照组TT型表达明显高于研究组,SNP rs7968682中GT型表达占比明显高于对照组(P<0.05);研究组ISS患儿血清IGF-1明显低于对照组(P<0.05);...     

矮小症学龄儿童血液中钙、镁、铁、锌水平与体格发育的相关性分析

目的 分析矮小症学龄儿童血液内血钙(Ca)、镁(Mg)、铁(Fe)、锌(Zn)水平与体格发育的相关性.方法 选择2016年1月至2017年8月来医院儿保门诊就诊的50例矮小症学龄儿童作为观察组,选择同期来我院体检的50例正常儿童作为对照组,均采集静脉血测定血清Ca、Mg、Fe、Zn水平,并进行体格检查,测定身高、胸围、体重,采用世界卫生组织推荐的美国国家卫生统计中心(NCHS)制定的相关标准评价其体格发育情况,分析矮小症儿童血清钙、镁、铁、锌等矿物质水平与其体格发育的相关性.结果 观察组身高、胸围、体重及血清Ca、Fe、Zn水平均低于对照组,比较差异有统计学意义(P＜0.05);观察组低钙、低铁、低锌检出率均高于对照组,比较差异有统计学意义(P＜0.05);矮小症学龄儿童血清Ca水平与身高、体重、胸围呈正相关,Fe与身高呈正相关,Zn与身高、体重、胸围均呈正相关(P＜0.05).结论 矮小症学龄儿童血清Ca、Fe、Zn水平低于正常健康儿童,且缺钙、缺铁、缺锌均影响儿童体格发育.     

矮小症患儿生长激素激发试验与治疗反应的相关性

目的分析生长激素缺乏症(GHD)和特发性矮小症(ISS)患者生长激素激发试验结果,及其与重组人生长激素(rhGH)治疗反应之间的关系。方法回顾性分析36例GHD和24例ISS左旋多巴和胰岛素低血糖生长激素激发试验结果,rhGH治疗后身高增长情况,进行相关性分析。结果 GHD组两种激发试验峰值、曲线下面积(area under curve, AUC)与身高标准差比值(SDS)呈正相关(P0.001),校正性别、年龄、骨龄、体质量SDS后,左旋多巴激发试验峰值及AUC与身高SDS仍呈正相关(r=0.471和0.427,P0.05);ISS组并无此相关性。两组治疗前身高SDS无差异,治疗第2年GHD组身高SDS显著高于ISS组(P0.05)。两组治疗后GV均明显增加,但治疗第2年GV较第1年有所下降。GHD组治疗第1年GV与治疗前两种激发试验峰值、AUC呈负相关,而ISS组并无相关性。结论 rhGH可显著改善GHD和ISS患儿身高,但随着治疗的延长GV有下降趋势;治疗前GH激发试验可一定程度预测GHD患儿rhGH治疗效果,但不能预测ISS患儿rhGH治疗效果。     

血清IGF-1和IGFBP-3在矮小症患儿中的诊断意义

探讨胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)在矮小症患儿诊断中的价值.对青春发育前矮小症患儿92例,健康儿童(对照组)48名,用精氨酸激发试验和胰岛素低血糖激发试验检测血清生长激素(GH)水平,并根据患儿GH峰值分为完全性生长激素缺乏(CGHD组,20例)、部分性生长激素缺乏(PGHD组,38例)、特发性矮小(ISS组,34例).采用CLIA检测血清IGF-1和IGFBP-3.对CGHD组、PGHD组、ISS组和对照组血清IGF-1和IGFBP-3水平进行两两比较发现,除PGHD组和ISS组间无显著性差异外(P＞0.05),均有显著性差异(P＜0.01).本文结果显示血清IGF-1和IGFBP-3检测对矮小症患儿有重要意义,可以作为确诊CGHD有价值的指标,但对于PGHD和ISS患儿则需结合GH激发试验加以鉴别.     

重组人生长激素治疗特发性矮小症对患儿血清p21 waf/cip1、瘦素水平及生长情况的影响

探究重组人生长激素治疗特发性矮小症（ISS）对患儿血清p21 waf/cip1、瘦素（LP）水平及生长情况的影响。114例ISS患儿随机分为常规治疗的对照组（ n=57）和联合重组人生长激素治疗的观察组（ n=57）。治疗12个月,两组血清IGF-1、IGFBP3、LP及身高、生长速度、预测成年身高...     

特发性矮小症患儿rhGH治疗前后血清BMP-2、TAZ水平变化及其预后价值

目的 探讨特发性矮小症(ISS)患儿rhGH治疗前后骨形态发生蛋白-2(BMP-2)、转录联合激活因子(TAZ)水平变化及其预后价值。方法 选取2019年3月至2020年3月本院儿科收治的儿童120例，收集整理其基本临床资料。以治疗前血清BMP-2、TAZ水平均值设置为基础值，接受rhGH治疗1个月(30d)后血清BMP-2、TAZ水平升高至基础值30%以上为敏感组(n=81),其他设置为非敏感组(n=39)。ELISA法测试患儿血清BMP-2、TAZ水平，并检测计算患儿生长发育指标、骨代谢指标、甲状腺指标、空腹血糖及糖化血红蛋白等指标。结果 敏感组rhGH治疗1个月、12个月、24个月后BMP-2、TAZ、GV、PAH、BAP、PINP水平较治疗前显著提高，且随时间变化显著增加(P<0.05);β-CTX水平较治疗前显著降低，且随时间变化显著降低(P<0.05)。敏感组与不敏感组治疗前后TSH、FT₃、FT₄、空腹血糖、糖化血红蛋白均无显著变化(P<0.05)。治疗1个月、12个月、24个月后敏感组血清BMP-2、TAZ水...     

不同剂量重组人生长激素治疗小儿特发性矮小症的临床对比研究

目的:对比研究不同剂量重组人生长激素(recombinant human growth hormone,rhGH)治疗小儿特发性矮小症(Idiopathic short stature,ISS)的临床价值.方法:收集本院2017年4月至2020年4月收治的116例ISS患儿的临床资料.根据不同剂量rhGH将116例患儿分为A组(rhGH剂量0.1 U?(kg?d)-1)与B组(rhGH剂量为0.2 U?(kg?d)-1).比较两组身高、体重变化情况,并计算生长速度(Growth velocity,GV)、骨龄、血清胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(Insulin like growth factor binding protein-3,IGFBP-3)、骨钙素(Osteocalcin,OC)、血清25羟维生素D[25(OH)D]、血清游离三碘甲腺原氨酸(Free triiodothyronine,FT3)、促甲状腺激素(Thyroid stimulating hormone,TSH)、游离甲状腺素(Free thyroxine,FT4)及不良反应发生情况.结果:治疗后,两组患儿身高、体重及IGF-1、IGFBP-3、OC、25(OH)D、FT3、FT4水平均较治疗前增高,TSH水平较治疗前下降,B组增高/降低程度明显优于A组;且B组治疗后GV、骨龄均明显高于A组(P<0.05).两组不良反应发生率无差异.结论:高剂量rhGH治疗ISS患儿效果更显著,更有助于促进患儿生长,改善患儿骨代谢,且安全可靠.     

精氨酸与可乐定激发试验联合使用在矮小儿童诊断中的应用

目的:探讨生长激素(GH)、精氨酸与可乐定激发试验联合在矮小儿童诊断中的临床价值.方法:分析对119例矮小儿童和100例正常儿童均进行GH、精氨酸与可乐定激发试验,采用放射免疫分析分别测定激发试验前和激发试验后30min、60min、90min的GH值,并分析比较.结果:矮小儿童与正常儿童比较,空腹血清GH水平无显著性...     

2型糖尿病患者血清GH、IGF-1及血清三蛋白测定的临床意义

生长激素／胰岛素样生长因子１（ＧＨ／ＩＧＦ-１）轴是体内重要的合成代谢调节系统。本文通过４８例２型糖尿病患者及３６例正常健康对照人血清ＧＨ、ＩＧＦ-１及血清三蛋白（β２-ｍ、ＩｇＧ、α１-ｍ）的测定 ,对２型糖尿病肾功能损伤的影响因素作进一步探讨 ,现报道如下。资料和方法一、对象 :糖尿病患者４８例（男３０ ,女１８） ,年龄４２～６２岁 ,为近一年来在我院干疗科住院病人 ,符合１９８５年ＷＨＯ标准的２型糖尿病 ,经饮食加口服药物治疗的患者 ;对照组３６例（男２８ ,女８）年龄４２～６２岁 ,均为我院经体检确认除外肝、肾…     

Efficacy of Short-Term Growth Hormone Treatment in Prepubertal Children with Idiopathic Short Stature

Purpose

It has been reported that daily recombinant human growth hormone (GH) treatment showed beneficial effects on growth in prepubertal children with idiopathic short stature (ISS). The present study aimed to validate the GH (Eutropin®) effect on growth promotion and safety after short-term GH treatment.

Materials and Methods

This study was an open-label, multicenter, interventional study conducted at nine university hospitals in Korea between 2008 and 2009. Thirty six prepubertal children with ISS were enrolled in this study to receive 6-month GH treatment. Yearly growth rate, height standard deviation score (SDS), and adverse events were investigated during treatment.

Results

After 26 weeks of GH treatment, the height velocity significantly increased by 6.36±3.36 cm/year (p<0.001). The lower end of one-sided 95% confidence interval was 5.22 cm/year, far greater than the predefined effect size. The gain in height SDS at week 26 was 0.57±0.27 (p<0.0001). Bone age significantly increased after GH treatment, however, bone maturation rate (bone age for chronological age) showed limited advancement. This 26-week GH treatment was effective in increasing serum levels of insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-3 from baseline (p<0.0001). Eutropin was well tolerated and there were no withdrawals due to adverse events. No clinically significant changes in laboratory values were observed.

Conclusion

This 6-month daily GH treatment in children with ISS demonstrated increased height velocity, improved height SDS, and increased IGF-I and IGFBP-3 levels with a favorable safety profile.     

Effect of training on GH and IGF-1 responses to a submaximal exercise in football players

To study the effects of regular football training on basal and exercise induced levels of growth hormone (GH) and insulin-like growth factor (IGF-1), 13 young football players were investigated by a submaximal exercise at the beginning of the sporting season in October (S1), at the middle of the season in January (S2) and at the end in May (S3). At each session, an exercise test on an ergogycle was performed for 25 min, beginning with an incremental exercise to reach 90% of theoretical maximal heart, which was maintained for the last 10 min of the test. Venous blood samples were collected at rest, at the end of the exercise and at 30 and 60 min during the recovery period. Plasma lactate and glucose concentrations increased during exercise with no difference found between sessions. GH level increased with exercise at each session but the response was significantly higher in S1 than in S2 and S3 (P<0.01). The GH area under the curve decreased significantly all along the football season (P<0.01); the IGF-1 level did not significantly change during exercise nor with training. Basal insulin-like growth factor binding protein-3 (IGFBP3) remained stable during the three sessions. Football training decreased significantly the exercise-stimulated GH levels all along the football season but did not have any significant effect on IGF-1 levels or on basal IGFBP3 levels.     

Modulation of GH/IGF-1 axis: potential strategies to counteract sarcopenia in older adults

Aging is associated with progressive decline of skeletal muscle mass and function. This condition, termed sarcopenia, is associated with several adverse outcomes, including loss of autonomy and mortality. Due to the high prevalence of sarcopenia, a deeper understanding of its pathophysiology and possible remedies represents a high public health priority. Evidence suggests the existence of a relationship between declining growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels and age-related changes in body composition and physical function. Therefore, the age-dependent decline of GH and IGF-1 serum levels may promote frailty by contributing to the loss of muscle mass and strength. Preclinical studies showed that infusion of angiotensin II produced a marked reduction in body weight, accompanied by decreased serum and muscle levels of IGF-1. Conversely, overexpression of muscle-specific isoform of IGF-1 mitigates angiotensin II-induced muscle loss. Moreover, IGF-1 serum levels have been shown to increase following angiotensin converting enzyme inhibitors (ACEIs) treatment. Here we will review the most recent evidence regarding age-related changes of the GH/IGF-1 axis and its modulation by several interventions, including ACEIs which might represent a potential novel strategy to delay the onset and impede the progression of sarcopenia.     

Association of Polymorphisms in the Vitamin D Receptor Promoter with Idiopathic Short Stature

The genetic alterations of vitamin D receptor (VDR) are related with the growth of long bone. There were a lot of reports regarding an association of polymorphisms in the VDR promoter with many disorders, but not with idiopathic short stature (ISS). We investigated the association of them with ISS. A total of 50 subjects, including 29 ISS patients and 21 healthy controls with their heights within the normal range was recruited. We selected two single nucleotide polymorphisms (SNPs) from VDR promoter (rs11568820 at the Cdx-2 binding site upstream of exon 1e and rs4516035 at -1012 upstream of exon 1a) as candidates, respectively. In genotype analysis, the frequency of A/A genotype at the Cdx-2 binding site locus (rs11568820) upstream of exon 1e of VDR was decreased to 6.9% in ISS patients (28.6% in controls) (P = 0.027). The genetic variation at the Cdx-2 binding site of VDR promoter can be a contributing factor of growth of height.     

生长激素和泌乳素在SLE患者血清中的表达及其与SLE病情程度的相关性研究

目的 研究生长激素(GH)和泌乳素(PRL)在SLE患者血清中的表达及其与SLE病情程度的相关性.方法 将105例SLE患者根据活动评分分为4个等级,分别为无活动患者,轻度活动患者,中度活动患者,重度活动患者.选取86例正常健康者作为对照组.每组抽取静脉血5mL,ELISA试剂盒检测血清中GH和PRL的水平.结果 SLE患者血清中GH和PRL的水平较正常对照组显著升高(P＜0.01),且不同病理分级中的水平也不同,其中重度组的水平最高,中度、轻度、无活动期患者血清中的水平依次降低,但均比正常对照组水平高(P＜0.01).结论 GH、PRL在SLE患者血清中的表达较正常对照组显著升高,且随着病情程度的加重,其水平逐渐增加,这为SLE患者的进一步研究提供了有力的理论依据.     

结直肠癌患者手术前后血清IGF-1水平变化及临床价值分析

目的 用酶联免疫吸附测定法检测结直肠癌患者手术前后血清 IGF-1的含量,并探讨其手术前后血清水平变化及在结直肠癌发生发展中的作用。方法 选取在佳木斯大学附属第一医院首次确诊并行结直肠癌切除术患者共30例为观察组,于手术前清晨及术后30 d采集空腹静脉血。选取同时期体检健康者30例为对照组,采集体检当日空腹静脉血。用Elisa法检测两组患者血清IGF-1的含量,观察血清IGF-1含量在两组中的变化规律,分析IGF-1与结直肠癌临床各参数的关系。结果 观察组术前血清IGF-1水平为（200.48±42.25）ng/ml,高于观察组术后的（164.52±35.45）ng/ml和对照组的（146.26±43.14）ng/ml,差异有统计学意义（P＜0.05）;观察组术后血清IGF-1水平较对照组稍高,但差异无统计学意义（P＞0.05）;高分化、中分化者血清IGF-1水平低于低分化者,差异有统计学意义（P＜0.05）;Dukes分期中A+B和C+D期之间比较,差异有统计学意义（P＜0.05）。结论 结直肠癌患者血清IGF-1参与结直肠癌的病变过程,是一种有促进细胞增殖、分化等多种生物学活性的细胞因子,可能作为结直肠癌发生、发展的重要预测指标及手术切除后手术效果的评定指标之一。