Arnold W C, Uthne K, Spencer E M, Piel C, Holliday M A
Int J Pediatr Nephrol. 1983 Mar;4(1):29-34.
The relationship of energy intake, growth rate and serum concentration of somatomedin-A was evaluated in eighteen children with chronic renal insufficiency. Serum concentrations of somatomedin-A were found to be 0.84 micro/ml in normal children and were elevated to 3.06 micro/ml in children with chronic renal insufficiency prior to dialysis (p less than 0.01). Somatomedin-A concentrations increased during chronic hemodialysis to 5.81 micro/ml and decreased to 1.59 micro/ml following successful renal transplantation (p less than 0.01). Serum concentrations of somatomedin-A correlated with residual glomerular filtration rates (r = -0.5), serum creatinine concentration (r = 0.59), and blood urea nitrogen (r = 0.6). Growth rates correlated with energy intake (r = 0.58) and somatomedin-A concentrations (r = 0.4) in the children with chronic renal insufficiency. Both energy intake and somatomedin-A increased significantly after one year of nutritional supplementation. Our findings are consistent with the hypothesis that somatomedin, like other polypeptide hormones, is elevated in uremia and that increased energy intake may affect the growth of children with chronic renal insufficiency by increasing somatomedin levels.
对18名慢性肾功能不全患儿的能量摄入、生长速率与生长调节素A血清浓度之间的关系进行了评估。发现正常儿童生长调节素A的血清浓度为0.84微克/毫升，而透析前慢性肾功能不全患儿的血清浓度升高至3.06微克/毫升（p<0.01）。在慢性血液透析期间，生长调节素A浓度升高至5.81微克/毫升，成功进行肾移植后降至1.59微克/毫升（p<0.01）。生长调节素A的血清浓度与残余肾小球滤过率（r=-0.5）、血清肌酐浓度（r=0.59）及血尿素氮（r=0.6）相关。慢性肾功能不全患儿的生长速率与能量摄入（r=0.58）及生长调节素A浓度（r=0.4）相关。营养补充一年后，能量摄入和生长调节素A均显著增加。我们的研究结果与以下假设一致，即生长调节素与其他多肽激素一样，在尿毒症时升高，且能量摄入增加可能通过提高生长调节素水平影响慢性肾功能不全患儿的生长。
