Allen R C, Jimenez M, Cowell C T
Department of Rheumatology, Children's Hospital, Camperdown, Sydney, Australia.
Ann Rheum Dis. 1991 Sep;50(9):602-6. doi: 10.1136/ard.50.9.602.
Insulin-like growth factor (IGF-1) concentrations were determined in a series of 23 children with juvenile chronic arthritis in conjunction with anthropometric assessment. When standardised z scores were used significant decreases in height and weight were shown in comparison with the normal age/sex matched means. Severe growth disturbance was seen, particularly in those with prolonged disease duration, which was independent of corticosteroid treatment, indicating disease activity itself is a major factor in the growth retardation. Eight children had low IGF-1 z scores--that is, less than -2.00 from age/sex matched mean. Low IGF-1 z scores were associated with low weight z scores but not with low height z scores. Overnight growth hormone secretory profiles were determined in 10 patients, including seven with low IGF-1, and showed generally normal secretion in all but one patient, who subsequently attained normal concentrations coincident with catch up growth. Increased pulse frequency of overnight secretion was commonly seen. Low IGF-1 concentrations probably result from varying factors, particularly nutritional, but do not reflect marked endocrinological abnormalities in most patients.
在对23名青少年慢性关节炎患儿进行人体测量评估的同时，测定了胰岛素样生长因子（IGF-1）浓度。当使用标准化z分数时，与正常年龄/性别匹配均值相比，身高和体重出现显著下降。观察到严重的生长障碍，尤其是在病程较长的患儿中，这与皮质类固醇治疗无关，表明疾病活动本身是生长迟缓的主要因素。8名儿童的IGF-1 z分数较低，即比年龄/性别匹配均值低2.00以上。低IGF-1 z分数与低体重z分数相关，但与低身高z分数无关。对10名患者进行了夜间生长激素分泌情况测定，其中7名患者IGF-1较低，结果显示除1名患者外，其他患者的分泌情况总体正常，该患者随后随着追赶生长达到了正常浓度。夜间分泌的脉冲频率通常会增加。低IGF-1浓度可能由多种因素引起，尤其是营养因素，但在大多数患者中并不反映明显的内分泌异常。
