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Published on: January 7, 2016
Spontaneous growth hormone secretion and IGF1:IGFBP3 molar ratios in children born small for gestational age (SGA)
Thomas M K Völkl1, Katja Schwöbel, Diemud Simm
1Division of Pediatric Endocrinology, Hospital for Children and Adolescents, Friedrich-Alexander-University of Erlangen-Nuremberg, Loschgestrasse 15, 91054 Erlangen, Germany.
Insights
Children born small for gestational age (SGA) without catch-up growth show similar nocturnal growth hormone (GH) secretion and insulin-like growth factor (IGF) profiles compared to appropriate for gestational age (AGA) peers.
Area of Science:
- Pediatric Endocrinology
- Growth Disorders
- Hormone Secretion Analysis
Background:
- Small for gestational age (SGA) is associated with short stature.
- Postnatal catch-up growth is a key factor in SGA outcomes.
- Nocturnal growth hormone (GH) secretion and IGF-1/IGFBP-3 are crucial for growth.
Purpose of the Study:
- To compare spontaneous nocturnal GH secretion, IGF1, IGFBP3, and IGF1:IGFBP3 molar ratios in SGA children lacking catch-up growth with AGA controls.
- To investigate potential endocrine differences contributing to short stature in SGA children.
Main Methods:
- Retrospective matched-pair analysis of prepubertal short-statured children (SGA vs. AGA).
- Exclusion of GH deficiency via two standard GH stimulation tests.
- Assessment of spontaneous nocturnal GH secretion through frequent blood sampling (every 20 min for 10 h) and Pulsar analysis.
- Measurement of serum IGF1 and IGFBP3 levels.
Main Results:
- No significant differences in GH secretion parameters (Pulsar analysis) between SGA and AGA groups.
- IGF1 levels were lower (approx. -1 SDS) in both groups, while IGFBP3 levels were normal.
- IGF1:IGFBP3 molar ratios were significantly reduced in both SGA and AGA children.
- IGF1- and IGFBP3-SDS levels did not differ significantly between groups when related to chronological or bone age.
Conclusions:
- Matched SGA and AGA short children without catch-up growth exhibit comparable spontaneous nocturnal GH secretion.
- Similar IGF1, IGFBP3, and IGF1:IGFBP3 molar ratio profiles were observed between the SGA and AGA groups.
- These findings suggest that differences in nocturnal GH secretion and IGF parameters are not the primary drivers of short stature in SGA children without catch-up growth.
Objective:
To analyze spontaneous nocturnal GH profiles, IGF1 and IGFBP3 serum levels, as well as IGF1:IGFBP3 molar ratios in SGA children without postnatal catch-up growth.
Methods:
Short statured prepubertal SGA children (n = 24) were matched retrospectively for sex, age and BMI to short statured children born appropriate for gestational age (AGA), who underwent the same diagnostic program. GH deficiency was excluded in all children by a normal increase of GH in 2 stimulation tests (>8 microg/L). For assessment of spontaneous nocturnal GH secretion, GH serum levels were measured every 20 min for 10 h. Pulsatility was analyzed with Pulsar.
Results:
None of the Pulsar derived descriptive parameters showed a significant difference between SGA and AGA children. Overall, median IGF1 levels were approximately one SDS below zero SDS (p < 0.001), whereas IGFBP3 levels were normal in both groups. Thus, the IGF1:IGFBP3 molar ratios were significantly lower from zero (p < 0.01) in SGA as well as in AGA children. However, IGF1- and IGFBP3-SDS levels related either to chronological or to bone age did not differ significantly between SGA and AGA children.
Conclusions:
Building matched pairs of short statured children born either SGA or AGA for sex, age and BMI we did not find any significant differences in spontaneous nocturnal GH secretion, IGF1, IGFBP3, and IGF1:IGFBP3 molar ratios.
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