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Association between Insulin-Like Growth Factor-1 and Relative Skeletal Maturation: A Retrospective Cohort Study of
Qianqian Zhao1,2, Mei Zhang1,2, Yuntian Chu3
1Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong P.R. 272029, China.
Insights
Low insulin-like growth factor-1 (IGF-1) levels may cause delayed bone age (BA) in short children. This study found a nonlinear association between IGF-1 and BA maturation before and after growth hormone (GH) treatment.
Area of Science:
- Pediatric Endocrinology
- Skeletal Biology
- Growth and Development
Background:
- Delayed skeletal maturity in children is linked to bone mass and fracture risk.
- Factors influencing skeletal maturation in children are not fully understood.
Purpose of the Study:
- To investigate the association between insulin-like growth factor-1 (IGF-1) and skeletal maturation.
- To examine this association before and after growth hormone (GH) therapy in short children.
Main Methods:
- Retrospective cohort study of 783 short children and adolescents.
- Bone age (BA) assessed using Greulich and Pyle method; skeletal maturation defined as BA minus chronological age (BA-CA).
- Analysis of anthropometric data, laboratory values, and IGF-1 standard deviation scores (SDS).
Main Results:
- A significant positive association between IGF-1 SDS and BA-CA was observed when IGF-1 levels were above -2 SDS before GH therapy.
- After GH therapy, a significant positive association was found between IGF-1 SDS and BA-CA when IGF-1 levels were below 2 SDS.
- No significant relationship was observed between IGF-1 SDS and BA-CA at very low or very high IGF-1 levels, indicating a nonlinear association.
Conclusions:
- Bone age (BA) is frequently delayed in short children and adolescents.
- A nonlinear relationship exists between IGF-1 levels and BA maturation in short children, both before and after GH treatment.
- Low IGF-1 levels are suggested to contribute to delayed BA in this population.
Objective:
Delays in skeletal maturity are related to bone mass and fracture risk in children, but the factors that determine it are unknown. We aimed to identify the association between insulin-like growth factor-1 (IGF-1) and skeletal maturation before and after growth hormone (GH) treatment.
Methods:
In this retrospective cohort study, we observed 783 short children and adolescents, 229 of whom received GH therapy. Skeletal maturation was assessed based on the difference between bone age (BA) and chronological age (CA) (noted as BA-CA). Anthropometric data and laboratory values were measured, and BA was evaluated using the Greulich and Pyle method.
Results:
The delayed BA group was defined as BA-CA < -2 SD (n = 457), and the occurrence rate of BA delay was 58.37%. A nonlinear relationship was observed between the IGF-1 standard deviation score (IGF-1 SDS) and BA-CA before and after GH therapy. Before GH therapy, there was a significant positive association between the IGF-1 SDS and BA-CA when the IGF-1 level was greater than -2 SDS (β 0.17, 95% CI 0.08, 027; P < 0.001). However, we did not observe a significant relationship between the IGF-1 SDS and BA-CA when the IGF-1 level was lower than -2 SDS (β 0.07, 95% CI -0.12, 0.26; P = 0.454). After GH therapy, there was a significant positive association between the IGF-1 SDS and BA-CA when the IGF-1 level was lower than 2 SDS (β 0.20, 95% CI 0.12, 028; P < 0.001). However, we did not observe a significant relationship between the IGF-1 SDS and BA-CA when the IGF-1 level was greater than 2 SDS (β -0.03, 95% CI -0.33, 0.27; P = 0.866).
Conclusion:
BA is more delayed in short children and adolescents. There is a nonlinear relationship between IGF-1 and BA maturation in short children before and after GH treatment. These findings suggest that a low level of IGF-1 may contribute to BA delay in short children and adolescents.
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