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Insulin-like growth factor-1, growth hormone-dependent insulin-like growth factor-binding protein and growth in
E M Hodson1, A S Brown, L P Roy
1Department of Paediatrics, Westmead Hospital, New South Wales, Australia.
Insights
Growth retardation in children with chronic renal failure (CRF) is not linked to insulin-like growth factor-1 (IGF-1) or insulin-like growth factor-binding protein-3 (IGFBP-3) levels. These growth factors did not differ from healthy children or correlate with height SDS in CRF patients.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth Factor Research
Background:
- Chronic renal failure (CRF) in children is associated with growth retardation.
- Insulin-like growth factor-1 (IGF-1) and its binding protein, IGFBP-3, are crucial for growth.
- The role of IGF-1 and IGFBP-3 in pediatric CRF-related growth failure requires further elucidation.
Purpose of the Study:
- To investigate circulating levels of IGF-1 and IGFBP-3 in children with CRF.
- To examine the relationship between IGF-1, IGFBP-3 levels, and growth parameters in pediatric CRF.
- To determine if altered IGF-1 or IGFBP-3 levels contribute to growth retardation in children with CRF.
Main Methods:
- Radioimmunoassays were used to measure IGF-1 and IGFBP-3 levels in children with varying degrees of CRF.
- Study group 1 included 29 children (10 on dialysis) assessed over 2 years for IGF-1, IGFBP-3, and height standard deviation score (SDS).
- Study group 2 involved 19 children (7 on dialysis) prospectively monitored for 1-2 years for growth rates and nutritional parameters in relation to IGF-1 and IGFBP-3.
Main Results:
- IGF-1 and IGFBP-3 levels in children with CRF did not differ from age-matched healthy controls.
- No significant correlation was found between IGF-1 or IGFBP-3 levels (age-corrected) and height SDS in either dialysis or non-dialysis CRF patients.
- Growth rates and nutritional parameters in CRF patients did not significantly correlate with IGF-1 or IGFBP-3 levels over a 1-year period.
Conclusions:
- Growth retardation observed in children with chronic renal failure is not attributable to alterations in circulating IGF-1 or IGFBP-3 levels.
- The study suggests that other factors beyond IGF-1 and IGFBP-3 are responsible for impaired growth in pediatric CRF.
- Further research is needed to identify the specific mechanisms underlying growth failure in children with CRF.
Abstract:
Insulin-like growth factor-binding protein-3 (IGFBP-3) and insulin-like growth factor-1 (IGF-1) levels were measured by specific radioimmunoassays in children with all degrees of chronic renal failure (CRF). Study group 1 comprised 29 children (10 on dialysis) who had been studied one to four times over 2 years to determine whether IGF-1 and IGFBP-3 levels differed from those in age-matched healthy children and to examine the relationship between these levels and heights. IGF-1 and IGFBP-3 levels did not differ from those in normal children. IGF-1 and IGFBP-3 were significantly correlated, increased with pubertal stage in all children and with age in non-dialysis patients. IGF-1, but not IGFBP-3, correlated with age in dialysis patients. There was no correlation between IGF-1 or IGFBP-3 levels (corrected for age) and height standard deviation score (SDS) in either non-dialysis or dialysis patients. Study group 2 comprised 19 children (7 on dialysis) who were studied prospectively for 1-2 years to examine the relationship between IGF-1 and IGFBP-3 levels, growth rates and nutritional parameters. Mean values of IGF-1 and IGFBP-3 (corrected for age) did not change over 1-year periods, while height SDS fell by -0.38 +/- 0.21 SD/year in dialysis patients and by -0.11 +/- 0.29 SD/year in non-dialysis patients. No significant correlations were found between IGF-1 or IGFBP-3 levels and growth rates or nutritional parameters. Thus growth retardation in children with CRF is not related to circulating levels of IGF-1 or IGFBP-3.