ESPE Abstracts

Background: Adolescent growth spurt is the fast and intense increase in the rate of growth in height and weight that occurs during the adolescent stage of the human life cycle.

Objective and hypotheses: To investigate the changes of hormone levels and body composition in pubertal children with growth retardation.

Method: A non-randomised clinical controlled study was conducted in 208 cases (males 122, 10–14 years and females 86, 8–13 years) with growth retardation who were divided into two groups. Pubertal group (Tanner stages II–IV) included 104 cases, while prepubertal group (Tanner stage I) included 104 cases with matched age and sex frequencies. All patients received the clinical evaluation of height, weight, and pubertal stage by pediatric endocrinologists. All of those patients underwent GH stimulation testing after overnight fast, with a combination of arginine and clonidine. And blood biochemistry, thyroid function, insulin, C-peptide, IGF1, and bone age were measured. The statistical analysis was performed using SPSS 19.0. Comparisons between two groups were performed using t-test. A P value <0.05 was considered statistically significant.

Results: Compare with the prepubertal group, the mean peak GH of pubertal group was increased slightly but insignificantly (P=0.821), the level of IGF1 was increased significantly (1.48 times, P=0.000), and height SDS of puberty group increased by 0.39 SDS (P=0.001), while bone age increased by 1.3 years (P=0.000). Levels of insulin, C-peptide, and blood glucose of pubertal group were in normal range and increased significantly (P=0.003, P=0.003, and P=0.014). All of pubertal group had normal thyroid function, TSH level was increased slightly but insignificantly (P=0.625), FT₄ level was decreased slightly but insignificantly (P=0.082), while FT₃ level increased significantly (P=0.002). Blood lipid level remained constant, but the BMI was increased (P=0.044) in pubertal subjects. Furthermore, we divided our cases by sex, BMI of pubertal females increased significantly (P=0.007), and BMI of males increased slightly and insignificantly (P=0.406). TSH of puberty males decreased slightly and insignificantly (P=0.559), and TSH of puberty females remained constant (P=0.973).

Conclusion: The reaction of GH–IGF1 axis in children with growth retardation was poor during puberty. The height increased in pubertal group slightly, while bone age increased significantly, and growth time reduced, for pubertal children with growth retardation, treatments are urgent.