Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea.
J Korean Med Sci. 2023 Feb 20;38(7):e63. doi: 10.3346/jkms.2023.38.e63.
This study investigated the relationship between fibroblast growth factor 21 (FGF21) levels and growth in children with growth hormone deficiency (GHD) and idiopathic short stature (ISS), and the effects of the FGF21 level on response to growth hormone (GH) treatment.
We included 171 pre-pubertal children with a GHD (n = 54), ISS (n = 46), and normal height (n = 71). Fasting FGF21 levels were measured at baseline and every 6 months during GH treatment. Factors associated with growth velocity (GV) after GH therapy were investigated.
The FGF21 level was higher in short children than in the controls without significant difference between the GHD and ISS groups. In the GHD group, the FGF21 level was inversely associated with the free fatty acid (FFA) level at baseline ( = -0.28, = 0.039), however, was positively correlated with the FFA level at 12 months ( = 0.62, = 0.016). The GV over 12 months of GH therapy was positively associated with the delta insulin-like growth factor 1 level (β = 0.003, = 0.020). The baseline log-transformed FGF21 level was inversely associated with GV with marginal significance (β = -0.64, = 0.070).
The FGF21 level was higher in children of short stature, both those with GHD and the ISS, than in children with normal growth. The pretreatment FGF21 level negatively affected the GV of children with GH-treated GHD. These results suggest the existence of a GH/FFA/FGF21 axis in children.
本研究调查了成纤维细胞生长因子 21（FGF21）水平与生长激素缺乏症（GHD）和特发性身材矮小（ISS）患儿生长之间的关系，以及 FGF21 水平对生长激素（GH）治疗反应的影响。
我们纳入了 171 名青春期前的儿童，包括 GHD（n=54）、ISS（n=46）和正常身高（n=71）。在 GH 治疗期间，我们在基线和每 6 个月测量一次空腹 FGF21 水平。研究了与 GH 治疗后生长速度（GV）相关的因素。
与对照组相比，矮小儿童的 FGF21 水平较高，但 GHD 和 ISS 组之间无显著差异。在 GHD 组中，FGF21 水平与基线时的游离脂肪酸（FFA）水平呈负相关（= -0.28，= 0.039），但与 12 个月时的 FFA 水平呈正相关（= 0.62，= 0.016）。GH 治疗 12 个月后的 GV 与胰岛素样生长因子 1 的变化量呈正相关（β=0.003，=0.020）。基线时对数转换的 FGF21 水平与 GV 呈负相关，但具有边缘显著性（β=-0.64，=0.070）。
与正常生长的儿童相比，GHD 和 ISS 矮小儿童的 FGF21 水平更高。治疗前 FGF21 水平负性影响 GH 治疗的 GHD 患儿的 GV。这些结果表明儿童中存在 GH/FFA/FGF21 轴。
