Department of Pediatrics, Cairo University, Cairo, Egypt.
Horm Res Paediatr. 2013;79(5):277-82. doi: 10.1159/000350824. Epub 2013 Apr 26.
BACKGROUND/AIMS: Primary insulin-like growth factor-1 (IGF-1) deficiency (IGFD) is defined by low levels of IGF-1 without growth hormone (GH) deficiency and absence of secondary causes. The aim of this study was to evaluate IGF-1 in Egyptian children with idiopathic short stature (ISS) and describe patients with IGFD.
This cross-sectional study included 50 children with ISS following up at the Diabetes Endocrine and Metabolism Pediatric Unit at Cairo University Pediatric Hospital. Children were included based on the following criteria: (1) short stature with current height standard deviation score (SDS) ≤-2.5; (2) age between 2 and 9 years in boys and 2 and 8 years in girls, and (3) prepubertal status. Exclusion criteria were: (1) identified cause of short stature and (2) pubertal children. IGF-1-deficient children were defined as children without GH deficiency and with IGF-1 levels below the 2.5th percentile.
Among 50 children with ISS, 14 (28%) patients had low IGF-1 levels, consistent with the diagnosis of primary IGFD. When compared with non-IGFD children, IGFD children had lower birth weight SDS (-1.8 vs. -0.7 SDS, p < 0.0001) and lower height SDS (-4.2 vs. -3.1 SDS, p < 0.05) and more delayed bone age (2.6 vs. 1.6 years, p = 0.001).
Primary IGF-1 deficiency is found in 28% of children with ISS.
背景/目的：原发性胰岛素样生长因子-1（IGF-1）缺乏症（IGFD）定义为 IGF-1 水平低而无生长激素（GH）缺乏症，且无继发性病因。本研究旨在评估埃及特发性身材矮小（ISS）儿童的 IGF-1 水平，并描述 IGFD 患者的特征。
这项横断面研究纳入了在开罗大学儿科医院糖尿病内分泌与代谢儿科病房就诊的 50 名 ISS 儿童。患儿纳入标准为：（1）身高标准差评分（SDS）≤-2.5 的身材矮小；（2）年龄为 2-9 岁（男孩）和 2-8 岁（女孩）；（3）为青春前期状态。排除标准为：（1）明确的矮小病因；（2）青春期儿童。IGFD 患儿定义为无 GH 缺乏症且 IGF-1 水平低于第 2.5 百分位数的儿童。
在 50 名 ISS 儿童中，14 名（28%）患儿存在 IGF-1 水平降低，符合原发性 IGFD 的诊断。与非 IGFD 患儿相比，IGFD 患儿的出生体重 SDS 更低（-1.8 比-0.7 SDS，p<0.0001），身高 SDS 更低（-4.2 比-3.1 SDS，p<0.05），且骨龄延迟更明显（2.6 比 1.6 年，p=0.001）。
ISS 患儿中 28%存在原发性 IGF-1 缺乏症。
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