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Serum growth hormone-binding protein is decreased in prepubertal children with idiopathic short stature
N Dávila1, M Moreira-Andrés, J Alcañiz
1Department of Endocrinology, Hospital Puerta de Hierro, Universidad Autónoma, Madrid, Spain.
Insights
Children with idiopathic short stature (ISS) may have growth failure due to reduced growth hormone binding protein (GHBP) levels, suggesting possible growth hormone insensitivity. This finding points to potential defects at the growth hormone receptor level.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Idiopathic short stature (ISS) in children lacks definitively established causes.
- Peripheral growth hormone (GH) resistance, potentially linked to GH receptor alterations, is a suspected factor.
- Evaluating GH binding protein (GHBP) status offers insight into GH receptor function.
Purpose of the Study:
- To investigate the GHBP/receptor status in prepubertal children with ISS.
- To determine if GHBP levels correlate with growth failure in ISS.
- To explore potential GH insensitivity in children with ISS.
Main Methods:
- Studied 30 prepubertal children with ISS and 20 age-matched normal controls.
- Measured plasma GH binding protein (GHBP) activity using a GH-binding/gel chromatography assay.
- Assessed insulin-like growth factor-I (IGF-I) levels and GH secretion.
Main Results:
- Children with ISS exhibited significantly lower plasma GHBP activity (7.17 +/- 1.5%) compared to controls (12.02 +/- 2.04%).
- ISS group showed IGF-I levels below or in the low normal range, significantly different from controls.
- Growth retardation in the ISS group was -2.3 +/- 0.43 SD score with normal GH secretion.
Conclusions:
- Decreased GHBP levels in children with ISS suggest a degree of GH insensitivity.
- Findings indicate a potential defect at the GH-receptor level contributing to growth failure in ISS.
- Further research into GH receptor function is warranted for understanding ISS.
Abstract:
The causes for growth failure in children with idiopathic short stature (ISS) are not definitely established. Peripheral GH resistance due to changes at the level of the GH receptor has been suggested as one of the most probable explanation. In this study, we have selected a group of prepubertal children with ISS to evaluate the GHBP/receptor status by measuring the GH binding protein (GHBP) activity in plasma. Thirty prepubertal children with ISS (18 boys and 12 girls; age range: 4.79 to 11.33 yr) and twenty age-matched children with normal growth (11 boys and 9 girls) were studied. The ISS group presented growth retardation of -2.3 +/- 0.43 SD score (mean +/- SD) and normal GH secretion. Plasma IGF-I levels were below or in the low normal range (mean +/- SD: 136.3 +/- 62.3 micrograms/l, a concentration that was significantly different from IGF-I levels in the normal group (mean +/- SD: 187 +/- 57.5 micrograms/l p < 0.005). Plasma GHBP activity using a GH-binding/gel chromatography assay showed significantly lower values in ISS group (mean +/- SD: 7.17 +/- 1.5%) as compared with those of the control group (mean +/- SD: 12.02 +/- 2.04%; p < 0.001). There were no significant age- or sex-related differences in GHBP values in either group. The decreased GHBP levels observed in this group of children with ISS suggest that they may present a certain degree of GH insensitivity, probably due to a defect at the GH-receptor level.