Introduction: Growth retardation as clinical manifestation among children with acquired hypothyroidism is observed later in the course of the illness. Thyroid hormones along with insulin like growth factors (IGF) have important role in somatic and skeletal growth. Studies addressing role of IGFs towards growth retardation in children with acquired hypothyroidism are limited.
Objective: To evaluate effect of Insulin like growth factors in children with acquired hypothyroidism on growth parameters.
Methods: 27 children with acquired hypothyroidism, 818 years old recruited for evaluation after obtaining Institutional ethics clearance& informed consent. Height, weight, BMI recorded& analyzed on new IAP growth charts. Those with Growth hormone or multiple pituitary hormone deficiency and altered liver functions were excluded. Fasting samples for thyroid profile (T3, T4 & TSH), IGF1&IGFBP-3 collected. Thyroid profile analysed by electro-chemiluminiscence, IGF1, IGFBP-3 by enzyme linked immunoassay DRG Kit. Statistical analysis done using software version SPSS 17.0.
Results: 27 children (8 males, 19 females) had mean age of 13.77±3.09 years, height 138±15.4 cm (−2.53 S.D.), weight 35.89±11.67 kg (−1.09 S.D.) and BMI 18.25±3.26 (−0.34 S.D.). Stunting observed in 15/27(55.5%) (<−2 S.D.). Mean T3,T4 were normal. Mean TSH 19.81±30.7 μIU/ml was raised with significant negative correlation with height (r=0.56, P=0.035). Mean levels of IGF1 significantly lower than the age and sex matched normal population- 206.5±1.13 ng/ml, but IGFBP-3 was normal 4493±2375.67 ng/ml. Height had positive correlation with IGF-1 (r=0.36) but not with IGFBP-3. Significant positive correlation of IGFBP-3 was observed with weight (r=0.479, P=0.011) and BMI (r=0.538, P=0.004). TSH had negative correlation with IGF1 (r=−0.085), but no correlation observed with IGFBP-3.
Conclusion: Stunting observed in 55% children with acquired hypothyroidism. Significantly reduced IGF-1 levels along with abnormal TSH correlated positively with the height deficit in our cohort of acquired hypothyroid children. Though, IGFBP-3 was associated with increased weight & BMI. No correlation of IGFBP-3 observed with height or thyroid profile. Thus, IGF1 is associated with height deficit in children with acquired hypothyroidism.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology