Surmeli-Onay Ozge, Cindik Nimet, Kinik Sibel Tulgar, Ozkan Suleyman, Bayraktar Nilufer, Tokel Kursad
Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2011;24(7-8):483-7. doi: 10.1515/jpem.2011.061.
The aim of this study is to evaluate growth and insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) levels in infants with congenital heart disease (CHD) pre- and postoperatively over a period of a year. Anthropometric values and serum levels of IGF-1 and IGFBP-3 of 40 infants with CHD (20 cyanotic and 20 acyanotic) were compared with 32 healthy controls. Acyanotic infants and infants with pulmonary hypertension (PH) presented significantly more growth failure. Preoperatively, serum IGF-1 and IGFBP-3 levels were lower in the acyanotic group than the cyanotic and the control groups (p = 0.22; p < 0.01). The upward trend in IGF-1 and IGFBP-3 levels in this year-long study demonstrated that the values in the third month and the first year were higher than the preoperative values (p < 0.05). The parallel increase of weight gain and IGF-1, IGFBP-3 levels were the best evidence that these parameters are good nutritional indicators. Timing the corrective surgery before chronic malnutrition or PH develops is an important issue to maintain a normal growth for children with CHD.
本研究旨在评估先天性心脏病（CHD）患儿术前及术后一年内的生长情况以及胰岛素样生长因子1（IGF-1）和胰岛素样生长因子结合蛋白3（IGFBP-3）水平。将40例CHD患儿（20例青紫型和20例非青紫型）的人体测量值以及IGF-1和IGFBP-3的血清水平与32例健康对照进行比较。非青紫型患儿和患有肺动脉高压（PH）的患儿出现生长发育迟缓的情况明显更多。术前，非青紫型组的血清IGF-1和IGFBP-3水平低于青紫型组和对照组（p = 0.22；p < 0.01）。在这项为期一年的研究中，IGF-1和IGFBP-3水平呈上升趋势，表明第三个月和第一年的值高于术前值（p < 0.05）。体重增加与IGF-1、IGFBP-3水平的平行升高是这些参数是良好营养指标的最佳证据。在慢性营养不良或PH出现之前进行矫正手术的时机选择对于维持CHD患儿的正常生长是一个重要问题。
