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Serum IGF-I levels and growth failure in juvenile chronic arthritis
T J Aitman1, R G Palmer, J Loftus
1Clinical Research Centre, Harrow, Middlesex, U.K.
Insights
Serum insulin-like growth factor I (IGF-I) levels correlate with growth failure in children with Juvenile Chronic Arthritis (JCA). This finding is crucial for differentiating growth hormone secretion issues from action defects in JCA patients.
Area of Science:
- Pediatric Endocrinology
- Rheumatology
Background:
- Juvenile Chronic Arthritis (JCA) can lead to significant growth failure in affected children.
- Understanding the factors contributing to growth failure is essential for effective management and treatment.
Purpose of the Study:
- To investigate the association between serum insulin-like growth factor I (IGF-I) levels and growth parameters in children with JCA.
- To explore potential mechanisms underlying growth failure in JCA, including growth hormone (GH) secretion and action.
Main Methods:
- Assessed serum IGF-I levels in 32 children (aged 5-16 years) with JCA, encompassing a range of growth statuses.
- Measured height Standard Deviation Score (SDS) and height velocity.
- Correlated IGF-I levels with growth parameters and known risk factors for growth failure.
Main Results:
- A significant positive correlation was found between height SDS and serum IGF-I levels (rs = 0.49; p = 0.008).
- Height velocity also showed a significant correlation with IGF-I levels (rs = 0.41; p = 0.027).
- No correlation was observed between IGF-I levels and nutritional status or current steroid dose.
Conclusions:
- Serum IGF-I levels are associated with growth failure in children with JCA.
- The observed correlation suggests potential issues with either growth hormone (GH) secretion or GH action.
- Distinguishing between these mechanisms is vital for guiding GH-based therapies for short stature in JCA.
Abstract:
The association between growth failure and serum IGF-I levels has been assessed in 32 children with Juvenile Chronic Arthritis (JCA) aged 5-16 years. A spectrum from normal growth to severe growth failure was included in the study population. Height Standard Deviation Score (SDS) ranged from -5.79 to +1.41 (median -1.22) and Height Velocity from 0.72-8.85 cm/yr (median 3.81 cm/yr). Known risk factors for growth failure (disease activity, steroid treatment, vertebral collapse) were confirmed. Additionally, height SDS was significantly correlated with serum IGF-I levels (rs = 0.49; p = 0.008); height velocity was significantly, although less strongly correlated with IGF-I levels (rs = 0.41; p = 0.027). There was no correlation between IGF-I levels and either of two indices of nutritional status, or between IGF-I levels and current steroid dose. The correlation of serum IGF-I with parameters of growth failure may be due to either insufficient secretion of growth hormone (GH) or defective GH action. In view of the recently increased availability of GH for treatment of short stature, it is important to distinguish between these two mechanisms.