Rosenfeld R G
Department of Pediatrics, Oregon Health Sciences University, Portland 97201-3098, USA.
Acta Paediatr Suppl. 1997 Nov;423:17-9. doi: 10.1111/j.1651-2227.1997.tb18363.x.
Gene knockout studies in mice, and a recent case report, have demonstrated that insulin-like growth factors (IGFs) are major mediators of pre- and postnatal growth, whereas the growth-promoting role of growth hormone (GH) appears to be confined largely to the postnatal period. The IGF axis is now known to consist of the growth factors themselves and at least seven, and probably ten, IGF-binding proteins. These act either by regulating the availability of IGFs to their receptors, or directly on their target cells. Because of the difficulties associated with GH provocative testing, the central role of IGFs in pre- and postnatal growth, and the ease of assaying the various components of the IGF axis, it is suggested that the differential diagnosis of short stature should be based on the concept of IGF deficiency rather than on GH secretory status.
对小鼠的基因敲除研究以及最近的一例病例报告表明，胰岛素样生长因子（IGFs）是出生前和出生后生长的主要调节因子，而生长激素（GH）的促生长作用似乎主要局限于出生后阶段。现在已知IGF轴由生长因子本身以及至少七种、可能多达十种IGF结合蛋白组成。这些蛋白要么通过调节IGF与其受体结合的可利用性起作用，要么直接作用于其靶细胞。由于与GH激发试验相关的困难、IGFs在出生前和出生后生长中的核心作用以及检测IGF轴各成分的便利性，有人提出身材矮小的鉴别诊断应基于IGF缺乏的概念，而非GH分泌状态。
