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Insulin-like growth factor-I in prednisolone-treated children
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Insights
Long-term steroid therapy in children significantly increases plasma insulin-like growth factor 1 (IGF-I) levels. This suggests steroid-induced growth suppression is not due to impaired IGF-I production but defective IGF-I action.
Area of Science:
- Pediatric Endocrinology
- Pharmacology
Background:
- Long-term steroid therapy is associated with impaired linear growth in children.
- The precise mechanism underlying steroid-induced growth suppression requires further elucidation.
Purpose of the Study:
- To investigate the effect of prednisolone on plasma insulin-like growth factor 1 (IGF-I) levels in children.
- To determine if altered IGF-I production contributes to steroid-induced growth impairment.
Main Methods:
- A longitudinal study involving 11 children receiving prednisolone treatment.
- Measurement of plasma IGF-I levels before and during long-term prednisolone therapy (minimum 10 days).
Main Results:
- Plasma IGF-I levels significantly increased during long-term prednisolone therapy (mean 2.95 +/- 1.16 mu/ml) compared to baseline (mean 1.39 +/- 1.03 mu/ml).
- This increase was significant (P < 0.001) and observed only after prolonged treatment, not shortly after administration.
- No significant change in IGF-I levels was noted shortly after prednisolone administration.
Conclusions:
- Steroid-induced growth suppression in children is unlikely to be caused by impaired IGF-I production.
- The findings suggest a defective IGF-I action, possibly due to end-organ unresponsiveness or somatomedin inhibitors, contributes to growth impairment.
Abstract:
Impaired linear growth is a well-known side effect of long-term steroid therapy in children. To assess the steroid effects on plasma insulin-like growth factor 1 (IGF-I), 11 children with prednisolone treatment were evaluated for longitudinal study of IGF-I changes. The mean plasma IGF-I level without prednisolone use was 1.39 +/- 1.03 mu/ml, while that on prednisolone therapy for a minimum of 10 days was 2.95 +/- 1.16 mu/ml. A significant increase in plasma IGF-I concentrations was noted during long-term (more than 10 days) prednisolone therapy (P less than 0.001), but not found shortly after prednisolone administration. Our findings suggest that growth suppression of the steroid is not due to impaired IGF-I production, but rather, due to a defective IGF-I action either by end-organ unresponsiveness or via somatomedin inhibitors.