Bleicher Marlene, Högel Josef, Wudy Stefan, Wabitsch Martin, Homoki Janos, Sorgo Wolfgang, Heinze Eberhard
Department of Pediatrics, University of Ulm, Germany.
Horm Res. 2002;58(5):229-32. doi: 10.1159/000066266.
To investigate the possible contribution of plasma cortisol and growth hormone (GH) as reflected by insulin-like growth factor-I (IGF-I)/insulin-like growth factor-binding protein-3 (IGFBP-3) on insulin action in short-statured children.
In this study, insulin resistance (HOMA) was determined in 34 normal short-statured (age 9.4 +/- 3.5 years) and in 19 GH-deficient children (age 10.4 +/- 2.2 years). HOMA was examined in relation to fasting plasma cortisol, IGF-I, IGFBP-3 and in addition to birthweight and body mass index (BMI).
Birthweight was not correlated to insulin resistance. In GH-deficient children, BMI was significantly augmented and was associated with HOMA (p < 0.02). In both groups of patients, fasting plasma cortisol was related to HOMA (normal: r = 0.295, p < 0.05, GH-deficient: r = 0.495, p < 0.02). Only in normal short-statured children IGF-I (r = 0.338, p < 0.03) and IGFBP-3 (r = 0.493, p < 0.002) were associated with insulin resistance.
The results indicated that at a young age cortisol contributed to insulin resistance in short-statured children. In normal short-statured children HOMA was associated with IGF-I and IGFBP-3. Possibly GH, a known cause of insulin resistance, contributed to HOMA as IGF-I and IGFBP-3 do not mediate insulin resistance but reflect growth hormone secretion. The results in GH-deficient children supported this conclusion as in the absence of GH insulin resistance was not associated with IGF-I/IGFBP-3.
研究胰岛素样生长因子-I（IGF-I）/胰岛素样生长因子结合蛋白-3（IGFBP-3）所反映的血浆皮质醇和生长激素（GH）对身材矮小儿童胰岛素作用的可能影响。
本研究测定了34名正常身材矮小儿童（年龄9.4±3.5岁）和19名生长激素缺乏儿童（年龄10.4±2.2岁）的胰岛素抵抗（HOMA）。研究了HOMA与空腹血浆皮质醇、IGF-I、IGFBP-3的关系，此外还研究了与出生体重和体重指数（BMI）的关系。
出生体重与胰岛素抵抗无关。在生长激素缺乏儿童中，BMI显著升高且与HOMA相关（p<0.02）。在两组患者中，空腹血浆皮质醇均与HOMA相关（正常组：r=0.295，p<0.05；生长激素缺乏组：r=0.495，p<0.02）。仅在正常身材矮小儿童中，IGF-I（r=0.338，p<0.03）和IGFBP-3（r=）与胰岛素抵抗相关。
结果表明，在幼年时，皮质醇导致身材矮小儿童出现胰岛素抵抗。在正常身材矮小儿童中，HOMA与IGF-I和IGFBP-3相关。可能是生长激素（已知的胰岛素抵抗原因）导致了HOMA，因为IGF-I和IGFBP-3并不介导胰岛素抵抗，而是反映生长激素的分泌。生长激素缺乏儿童的结果支持了这一结论，因为在缺乏生长激素的情况下，胰岛素抵抗与IGF-I/IGFBP-3无关。
