Flint Janna, Wu Shufang, Shott Susan, Suarez Elizabeth, De Luca Francesco
Women's and Children's Hospital, 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508, USA.
J Pediatr Endocrinol Metab. 2009 Dec;22(12):1105-12. doi: 10.1515/jpem.2009.22.12.1105.
GH deficiency places children at risk for decreased bone density and increased fracture rates. The RANKL/RANK/OPG system plays an important role in linking bone formation to bone resorption. Although OPG is thought to be secreted as a compensatory response to states of low bone density, its concentrations have not been found to differ significantly between GH-deficient, acromegalic, and healthy adults.
To evaluate the associations between OPG and RANKL serum levels and GH secretory status in children.
54 short children were recruited.
Serum OPG and RANKL, IGF-I, IGFBP-3, stimulated GH levels, bone DEXA results, and growth velocity were assessed. Regression modeling was used to evaluate significant predictors of OPG and RANKL levels.
There were no significant differences in OPG and RANKL serum levels or bone DEXA results between GH-deficient and GH-sufficient children. A statistically significant quadratic relationship between OPG and IGFBP-3 concentrations was observed.
IGFBP-3 was found to be the only significant predictor of OPG serum levels, allowing us to speculate that increased OPG levels may represent a compensatory response to the missing anabolic actions of IGF-I and/or GH in children with GH deficiency.
生长激素缺乏使儿童面临骨密度降低和骨折率增加的风险。核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素系统在将骨形成与骨吸收联系起来方面发挥着重要作用。尽管骨保护素被认为是作为对低骨密度状态的一种代偿反应而分泌的，但在生长激素缺乏的成年人、肢端肥大症患者和健康成年人之间，尚未发现其浓度有显著差异。
评估儿童骨保护素和核因子κB受体活化因子配体血清水平与生长激素分泌状态之间的关联。
招募了54名身材矮小的儿童。
评估血清骨保护素、核因子κB受体活化因子配体、胰岛素样生长因子-I、胰岛素样生长因子结合蛋白-3、刺激后的生长激素水平、骨密度测定结果和生长速度。采用回归模型评估骨保护素和核因子κB受体活化因子配体水平的显著预测因素。
生长激素缺乏和生长激素充足的儿童之间，骨保护素和核因子κB受体活化因子配体血清水平或骨密度测定结果没有显著差异。观察到骨保护素与胰岛素样生长因子结合蛋白-3浓度之间存在统计学上显著的二次关系。
发现胰岛素样生长因子结合蛋白-3是骨保护素血清水平的唯一显著预测因素，这使我们推测，骨保护素水平升高可能是生长激素缺乏儿童对胰岛素样生长因子-I和/或生长激素缺失的合成代谢作用的一种代偿反应。
