The Growth Predictive Value of (IGF1/Growth Hormone Peak) Ratio in Children with Idiopathic Short Stature (ISS)

Ashraf Soliman; Fawzia Alyafei; Nada Alaaraj; Noor Hamed; Shayma Ahmed

Introduction: Stimulated GH peak values have been shown to correlate well with nocturnal GH peak values and with nocturnal mean GH values. In addition, the expression level of serum IGF-1 in ISS has been shown to be significantly lower than that in normal children despite their normal GH peak response to provocation. GH stimulates the production of IGF1; however, their metabolic effects are different. GH has lipolytic and anti-insulin actions while IGF1 has insulin-like actions.

Objectives: To investigate the value of using the IGF1/GH peak ratio in the anthropometric assessment of children with idiopathic short stature (ISS).

Patients and Methods: 20 short children with ISS (HtSDS < -2, with normal GH response to provocation) were randomly selected. Their IGF1 level and their peak GH response to provocation were analyzed in relation to their growth data for 1 year of follow-up. followed for 1 year.

Results: Are presented in 3 tables:

Table 1 Growth and hormonal data of children with ISS are presented in table 1:
Age 1	Wt 1	Ht 1	HtSDS1	BMI1	BMI SDS1	IGF-I1	GH-P	IGF1/GHP
Mean	9.6	23.6	122.9	-2.1	15.2	-1.1	192.7	18.1	10.4
SD	2.8	7.2	15.6	0.5	1.5	0.8	126.5	5.8	9.0
	Age2	Wt 2	Ht 2	HtSDS2	BMI2	BMI SD2	wt gain g/day
Mean	10.7	28.5	130.5	-1.8	16.3	-0.7	12.6
SD	2.6	8.2	14.2	0.4	1.8	0.7	7.9

Table 2: Correlation of GHP, IGF1 and IGF1/GHP ratio on growth parameters at diagnosis
	Age 1	weight1	Ht1	HtSDS1	BMI1	BMI1 SD	IGF-I 1	GH-P
IGF-I 1	0.54	0.63	0.61	0.46	0.47	0.27	1.00
GH-P	-0.03	-0.21	-0.02	-0.04	-0.35	-0.36	0.03	1.00
IGF1/GP Ratio	0.37	0.66	0.43	0.39	0.68	0.48	0.51	-0.49

Table 3 Correlation of GHP, IGF1, and IGF1/GHP ratio on growth parameters after 1 year.
	GH-P	IGF-I 1	IGF1/GP Ratio
IGF1/GP Ratio	-0.49	0.51	1.00
Age2	-0.05	0.51	0.35
weight2	-0.24	0.60	0.59
IGF-1 2	-0.16	0.78	0.61
IGF1 incre	-0.21	0.14	0.36
wt gain2	-0.02	0.20	0.27
Height2	0.07	0.58	0.40
HtSDS 2	-0.08	0.55	0.53
BMI2	-0.28	0.43	0.60
BMI SDS2	-0.32	0.25	0.41
Delta BMI	-0.5	0.04	0.36
IGF1/GHP ratio highly correlated with the growth parameters (HtSDS, BMI, BMISD) before and after a year of follow-up. In addition, IGF1/GHP ratio correlated significantly with weight gain/day and with delta- BMI at 1 year of follow-up.

Conclusion: The IGF1/GHP ratio has significant growth predictive value in children with ISS.

ESPE Abstracts

P1-107