Ghrelin、Nesfatin-1与儿童矮小症的相关性研究  

Study on the Correlation between Ghrelin,Nesfatin-1 and Idiopathic Dwarf Disease

作　　者：解欣 苏延 王玉[2] 柏金秀[2] XIE Xin;SU Yan;WANG Yu(Department of Clinical Medicine,Hebei University,Baoding City,Hebei Province)

机构地区：[1]河北大学医学部临床医学系,河北省保定市071000 [2]河北大学附属医院儿科

出　　处：《医学理论与实践》2019年第19期3048-3050,共3页The Journal of Medical Theory and Practice

基　　金：河北省2019年度医学科学研究课题计划(20190938);河北大学附属医院青年基金项目(2017Q006);河北大学创新训练项目(201810075097)

摘　　要：目的:探究血清生长激素释放肽(Ghrelin)、摄食抑制因子(Nesfatin-1)水平监测在特发性矮小儿童中的应用及临床意义。方法:选择2018年4月—2019年4月于我院儿科就诊的36例特发性矮小症(ISS)患儿,以20名健康同龄儿童作为正常对照。给予36例患儿重组人生长激素(rhGH)治疗,比较2组患儿不同时刻血清Ghrelin水平、Nesfatin-1、IGF-1水平和生长速率。结果:(1)ISS患儿身高、生长速度、血清IGF-1表达水平显著低于对照组,血清Ghrelin表达水平显著高于对照组(P<0.05);血清Nesfatin-1表达水平无明显差异(P>0.05)。(2)ISS组患儿IGF-1、Ghrelin、Nesfatin-1与生长指标的相关性:ISS患儿血清IGF-1与生长速度呈正相关性(r=0.61,P<0.001);血清Ghrelin水平与生长速度呈负相关性(r=-0.405,P=0.014),与体重水平呈负相关性(r=-0.498,P=0.002);血清Nesfatin-1与BMI指数呈负相关性(r=-0.393,P=0.018)。(3)与治疗前相比,ISS患儿治疗后3、6个月身高、生长速度显著升高(P<0.05);血清IGF-1水平升高(P<0.05);血清Ghrelin水平降低(P<0.05);血清Nesfatin-1水平无明显差异(P>0.05)。结论:Ghrelin在调控儿童生长发育中起着重要作用,可作为判断儿童生长激素的重要指标,临床中也可将其作为临床治疗的标志以及时调整治疗方案,在ISS患儿生长障碍的病因中,营养热量的摄入不是主要原因。在身高干预过程中,需要注意优化ISS患儿的饮食结构,避免BMI指数增加,以保护骨龄,尽量保存生长空间。Objective:To investigate the application and clinical significance of serum growth hormone release peptide(Ghrelin)and Nesfatin-1 levels monitoring in idiopathic dwarf children.Methods:36 children with idiopathic dwarf disease were selected from April 2018 to April 2019,and 20 healthy children of the same age were taken as normal control.36 children were treated with recombinant human growth hormone(rhGH),and the serum Ghrelin levels,Nesfatin-1,IGF-1 levels and growth rates were compared in two groups at different times.Results:(1)The height,growth rate and serum IGF-1 expression level of ISS children were significantly lower than those of control group,and the serum Ghrelin expression level was significantly higher than that of control group(P<0.05);there was no significant difference in serum Nesfatin-1 expression level(P>0.05).(2)Correlation between IGF-1,Ghrelin,Nesfatin-1 and growth index in ISS group:serum IGF-1 in ISS group was positively correlated with growth rate(r=0.61,P<0.001);Serum Ghrelin level was negatively correlated with growth rate(r=-0.405,P=0.014)and body weight level(r=-0.498,P=0.002);there was a negative correlation between serum Nesfatin-1 and BMI index(r=-0.393,P=0.018).(3)Compared with the pre-treatment,the height and the growth rate of ISS children 3 or 6 months after treatment,increased significantly(P<0.05);Serum IGF-1 level increased(P<0.05);Serum Ghrelin levels decreased(P<0.05);there was no significant difference in serum Nesfatin-1 level(P>0.05).Conclusion:Ghrelin plays an important role in regulating the growth and development of children.It can be used as an important indicator to determine the growth hormone of children.It can also be used as a sign of clinical treatment to adjust the treatment plan in a timely manner.In the etiology of growth disorders in children with ISS,Nutritional caloric intake is not the main cause.During the height intervention process,attention needs to be paid to optimizing the diet structure of children with ISS,avoiding the increase of the BMI index

关 键 词：特发性矮小 生长激素 生长激素释放肽 摄食抑制因子 

分 类 号：R725[医药卫生—儿科]