摘要
Abstract
Objective To explore the trend of changes in serum insulin-like growth factor 1(IGF-1)and insulin-like growth factor binding protein 3(IGFBP3)levels during treatment in children with idiopathic short stature(ISS)and to analyze their relationship with therapeutic efficacy.Methods A total of 120 children with ISS who were admitted to The Fifth People's Hospital of Chongqing and Chongqing Youyou Baby Women and Children's Hospital between March 2019 and April 2022 were enrolled.All patients received recombinant human growth hormone(rhGH)therapy.Changes in clinical parameters were observed during the 9-month treatment period.A Logistic regression model was established to predict height gain satisfaction in children with ISS,and the model performance was subsequently validated.Results During treatment,height,weight,growth velocity(GV),predicted adult height,and serum levels of IGF-1,IGFBP3,Klotho,bone morphogenetic protein 2(BMP-2),transcriptional co-activator with PDZ-binding motif(TAZ),25-hydroxyvitamin D[25(OH)D],and fibroblast growth factor 23(FGF23)increased significantly compared with baseline,whereas serum levels of growth hormone releasing peptide(Ghrelin)and cyclin dependent kinase inhibitor 1A(p21 waf/cip1)decreased(F values ranged from 5.073 to 94.362,P<0.05).Main-effect analysis demonstrated that the time effect,group effect,and interaction effect differed significantly between the satisfactory growth group and the unsatisfactory growth group(P<0.001).Multivariate Logistic regression analysis revealed that older age,lower levels of IGF-1 and IGFBP3,and higher Ghrelin levels were risk factors for poor height gain in children with ISS(OR ranged from 1.558 to 3.424,P<0.05),whereas a lower baseline growth hormone(GH)level was identified as a protective factor(OR=0.477,P<0.05).The predictive model showed an accuracy of 90.39%,a sensitivity of 94.95%,and a specificity of 84.82%.Compared with height gain satisfaction in children with ISS,the area under the curve(AUC)was significantly increased(0.875 vs.0.858,Z=12.172,P<0.01).Conclusion Age,IGF-1,IGFBP3,baseline GH,and Ghrelin levels are important factors influencing height gain in children with idiopathic short stature.These indicators may be useful for predicting therapeutic efficacy in children with ISS.关键词
特发性矮小症/治疗过程/胰岛素样生长因子/胰岛素样生长因子结合蛋白3/变化趋势/疗效Key words
idiopathic short stature/treatment process/insulin-like growth factor/insulin-like growth factor binding protein 3/trend of change/efficacy分类
医药卫生
