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Published on: January 7, 2016
Relationship Between the Serum FGF21 Level and Growth in Children of Short Stature
Yun Jeong Lee1, So Yoon Jung2, Young Ah Lee1,3
1Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Insights
Fibroblast growth factor 21 (FGF21) is elevated in children with short stature. Higher baseline FGF21 levels in growth hormone-deficient children predict a poorer growth response to growth hormone therapy.
Area of Science:
- Pediatric Endocrinology
- Metabolic Research
- Growth Factor Signaling
Background:
- Investigated fibroblast growth factor 21 (FGF21) in pediatric short stature.
- Examined FGF21 in growth hormone deficiency (GHD) and idiopathic short stature (ISS).
- Assessed FGF21's impact on growth hormone (GH) treatment response.
Purpose of the Study:
- To determine the relationship between FGF21 levels and growth in children with GHD and ISS.
- To evaluate how FGF21 levels affect the response to GH therapy.
- To explore a potential GH/FFA/FGF21 axis in pediatric growth.
Main Methods:
- Recruited 171 pre-pubertal children (GHD, ISS, normal height).
- Measured fasting FGF21 levels at baseline and every 6 months during GH treatment.
- Analyzed factors associated with growth velocity (GV) post-GH therapy.
Main Results:
- FGF21 levels were higher in short children (GHD and ISS) compared to controls.
- In GHD, baseline FGF21 inversely correlated with free fatty acids (FFA), but positively at 12 months.
- Baseline FGF21 showed a marginal inverse association with 12-month growth velocity in GH-treated GHD patients.
Conclusions:
- Elevated FGF21 is characteristic of short stature in children, irrespective of GHD or ISS.
- Pre-treatment FGF21 levels negatively influenced growth velocity in GH-treated GHD children.
- Findings suggest a GH/FFA/FGF21 axis influencing growth in children.
Background:
This study investigated the relationship between fibroblast growth factor 21 (FGF21) levels and growth in children with growth hormone deficiency (GHD) and idiopathic short stature (ISS), and the effects of the FGF21 level on response to growth hormone (GH) treatment.
Methods:
We included 171 pre-pubertal children with a GHD (n = 54), ISS (n = 46), and normal height (n = 71). Fasting FGF21 levels were measured at baseline and every 6 months during GH treatment. Factors associated with growth velocity (GV) after GH therapy were investigated.
Results:
The FGF21 level was higher in short children than in the controls without significant difference between the GHD and ISS groups. In the GHD group, the FGF21 level was inversely associated with the free fatty acid (FFA) level at baseline (r = -0.28, P = 0.039), however, was positively correlated with the FFA level at 12 months (r = 0.62, P = 0.016). The GV over 12 months of GH therapy was positively associated with the delta insulin-like growth factor 1 level (β = 0.003, P = 0.020). The baseline log-transformed FGF21 level was inversely associated with GV with marginal significance (β = -0.64, P = 0.070).
Conclusion:
The FGF21 level was higher in children of short stature, both those with GHD and the ISS, than in children with normal growth. The pretreatment FGF21 level negatively affected the GV of children with GH-treated GHD. These results suggest the existence of a GH/FFA/FGF21 axis in children.
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