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Published on: October 16, 2013
Prevalence of IGF1 deficiency in prepubertal children with isolated short stature
T Edouard1, S Grünenwald, I Gennero
1Department of Paediatric Endocrinology, Hôpital des Enfants, Toulouse, France.
Insights
Twenty percent of prepubertal children with isolated short stature (SS) have primary Insulin-like Growth Factor 1 deficiency (IGFD). This condition may stem from nutritional deficits or delayed maturation, not just GH issues.
Area of Science:
- Pediatric Endocrinology
- Growth Disorders
- Metabolic Syndromes
Background:
- Primary Insulin-like Growth Factor 1 deficiency (IGFD) is characterized by low IGF1 levels without impaired GH secretion.
- Isolated short stature (SS) in children necessitates understanding underlying causes beyond GH deficiency.
Purpose of the Study:
- To determine the prevalence of non-GH deficient IGFD in prepubertal children with isolated SS.
- To characterize the clinical and auxological features of this specific pediatric population.
Main Methods:
- Retrospective analysis of children with isolated SS (height SDS ≤ -2.5, age ≥ 2 years, prepubertal).
- Exclusion of secondary causes of SS and rhGH therapy.
- IGFD defined by IGF1 levels ≤ -2 SDS in the absence of GH deficiency.
Main Results:
- 13 out of 65 (20%) children with isolated SS were diagnosed with primary IGFD.
- IGFD children exhibited higher birth weight and height SDS compared to non-IGFD peers.
- A significant delay in bone age maturation was observed in the IGFD group.
Conclusions:
- Primary IGFD affects 20% of prepubertal children with isolated short stature.
- The findings suggest that nutritional deficiency and maturational delay are potential contributors to IGFD.
- Further investigation into the pathophysiology of IGFD is warranted.
Background/Aims:
'Primary IGF1 deficiency (IGFD)' is defined by low levels of IGF1 without a concomitant impairment in GH secretion in the absence of secondary cause. The aims of this study were to evaluate the prevalence of non-GH deficient IGFD in prepubertal children with isolated short stature (SS) and to describe this population.
Methods:
This retrospective study included all children with isolated SS seen in our Pediatric Endocrinology Unit from January 2005 to December 2007. Children were included based on the following criteria: i) SS with current height SDS < or = -2.5, ii) age > or = 2 years, and iii) prepubertal status. Exclusion criteria were: i) identified cause of SS and ii) current or past therapy with rhGH. IGF1-deficient children were defined as children without GH deficiency and with IGF1 levels below or equal to -2 SDS.
Results:
Among 65 children with isolated SS, 13 (20%) had low IGF1 levels, consistent with a diagnosis of primary IGFD, four of which were born small for gestational age and nine were born appropriate for gestational age. When compared with non-IGFD children, IGFD children had higher birth weight (-0.7 vs -1 SDS, P=0.02) and birth height (-1.7 vs -2 SDS, P=0.04) and more delayed bone age (2.6 vs 1.7 years, P=0.03).
Conclusion:
The prevalence of primary IGFD was 20% in children with isolated SS. Concerning the pathophysiology, our study emphasizes that IGFD in some children may be secondary to nutritional deficiency or to maturational delay.
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