Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, Shandong, 272029, P.R. China.
BMC Endocr Disord. 2020 Aug 3;20(1):119. doi: 10.1186/s12902-020-00600-w.
The growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children's growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS.
A cross-sectional analysis was performed including 178 children and adolescents with ISS who were enrolled from March 2013 to February 2019. The related clinical and biochemical parameters were evaluated for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were performed.
The mean levels of IGF-1 standard deviation scores (SDS) and Hb were - 0.99 (- 1.60 - -0.09) and 131.81 ± 9.36 g/L, respectively. Univariate analysis displayed a significant positive association between Hb and IGF-1 SDS (P < 0.001). After adjusting for potential confounding factors, the positive relationship between Hb and IGF-1 SDS remained (P = 0.001). Furthermore, there was an inflection point for Hb in the curve. In a multivariate piecewise linear regression model, IGF-1 SDS was significantly positively associated with Hb when Hb concentrations were lower than 145 g/L (B 0.05; 95% CI 0.02, 0.07; P < 0.001). However, IGF-1 SDS decreased with increasing Hb levels when Hb concentrations were greater than 145 g/L (B -0.15; 95% CI -0.23, - 0.06; P = 0.001).
This study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with ISS. The levels of IGF-1 increased with the elevation of Hb, but when the concentration of Hb exceeded a certain range, with the increase of Hb, IGF-1 decreased instead.
生长激素/胰岛素样生长因子-1（GH/IGF-1）轴对于儿童的生长和发育调节至关重要。尽管内源性 GH 水平正常，但特发性身材矮小（ISS）患者的血清 IGF-1 浓度通常较低，其相关潜在因素尚不清楚。本研究旨在探讨 ISS 儿童 IGF-1 与血红蛋白（Hb）之间的关系。
采用横断面分析，纳入 2013 年 3 月至 2019 年 2 月期间的 178 例 ISS 患儿和青少年，评估每位患者的相关临床和生化参数。进行单变量分析、平滑曲线拟合和多元分段线性回归。
IGF-1 标准差评分（SDS）和 Hb 的平均值分别为-0.99（-1.60 至-0.09）和 131.81±9.36g/L。单变量分析显示，Hb 与 IGF-1 SDS 呈显著正相关（P<0.001）。调整潜在混杂因素后，Hb 与 IGF-1 SDS 的正相关关系仍然存在（P=0.001）。此外，Hb 与 IGF-1 SDS 的关系曲线存在拐点。在多元分段线性回归模型中，当 Hb 浓度低于 145g/L 时，IGF-1 SDS 与 Hb 显著正相关（B 0.05；95%CI 0.02，0.07；P<0.001）。然而，当 Hb 浓度大于 145g/L 时，IGF-1 SDS 随 Hb 水平的升高而降低（B -0.15；95%CI -0.23，-0.06；P=0.001）。
本研究表明，Hb 与中国 ISS 儿童和青少年的 IGF-1 相关。IGF-1 水平随 Hb 升高而升高，但当 Hb 浓度超过一定范围时，随着 Hb 升高，IGF-1 反而降低。
