IGF-1/IGFBP-3摩尔比值在矮身材患儿重组人生长激素治疗时的变化研究  

A Study of the Change of IGF-1/IGFBP-3 Molar Ratio in the Treatment ofShort Stature Recombinant Human Growth Hormone

作　　者：和秀梅 吴虹林 梁谊佳 何玺玉 HE Xiumei;WU Honglin;LIANG Yijia;HE Xiyu(Hebei North University,Zhangjiakou 075000,China;Department of Pediatrics,Fifth Medical Center,General Hospital of Chinese People’s Liberation Army,Beijing 100071,China;Graduate School of PLA Medical College,Beijing 100080,China;The Department of Pediatric Medicine of the Seventh Medical Center of the Chinese People’s Liberation Army General Hospital is accredited to the Department of Pediatric Medicine of the Fifth Medical Center,Beijing 100141,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]中国人民解放军总医院第五医学中心儿科,北京100071 [3]中国人民解放军医学院,北京100853 [4]中国人民解放军总医院第七医学中心儿科医学部派驻第五医学中心儿科,北京100141

出　　处：《标记免疫分析与临床》2023年第5期763-769,共7页Labeled Immunoassays and Clinical Medicine

基　　金：军队计生专项(编号:21JSZ16)。

摘　　要：目的观察不同病因矮身材患儿用重组人生长激素(rhGH)治疗1年期间IGF-1/IGFBP-3摩尔比值变化,为其评价rhGH治疗效果及安全性提供理论依据。方法研究对象为2017年5月至2022年11月就诊于我院门诊,随访1年且临床资料完整的67例矮身材患儿[小于胎龄儿(SGA)12例、生长激素缺乏症(GHD)18例和特发性矮身材(ISS)37例]。分别于初始治疗(治疗0月),治疗3、6、9、12月,记录3组患儿身高、体重、rhGH治疗相关不良反应事件,同时测定IGF-1水平、IGFBP-3水平,并计算IGF-1/IGFBP-3摩尔比值。同时将我院儿童保健门诊0~13岁正常健康体检儿童(247名)作为对照人群,收集临床资料,测定IGF-1、IGFBP-3水平,计算IGF-1/IGFBP-3摩尔比值。结果矮身材患儿的IGF-1/IGFBP-3摩尔比值与IGF-1水平呈正相关(r=0.843,P<0.001);IGF-1/IGFBP-3摩尔比值SDS与IGF-1SDS水平呈正相关(r=0.773,P<0.001);rhGH治疗1年期间,SGA、GHD及ISS患儿的IGF-1/IGFBP-3摩尔比值与IGF-1水平出现相应变化,且变化趋势相同,说明IGF-1/IGFBP-3摩尔比值也可以是评价矮身材rhGH治疗疗效的一个生物标志物。且当IGF-1水平超过2 SDS时,IGF-1/IGFBP-3摩尔比值相对稳定,未发现不良反应事件,表明IGF-1/IGFBP-3摩尔比值在rhGH治疗安全性评估中具有合理性。结论IGF-1/IGFBP-3摩尔比值是评价矮身材rhGH治疗的一个生物标志物;rhGH治疗期间,IGF-1/IGFBP-3摩尔比值在rhGH疗效和安全性评估中具有一定科学依据。Objective To observe changes of the molar ratio of IGF-1/IGFBP-3 in short stature children with different therapeutic effect and safety of rhGH when treated with recombinant human growth hormone(rhGH)for one year,so to provide theoretical basis for evaluating.Methods The study subjects were 67 short stature children(12 short stature for gestational age(SGA),18 short stature for growth hormone deficiency(GHD)and 37 short stature for idiopathic(ISS))who visited our hospital from May,2017 to November,2022 and were followed up for one year.During the initial treatment(0 month),and 3,6,9 and 12 months,respectively,height,weight and adverse events related to rhGH treatment were recorded,and concentrations of IGF-1 and IGFBP-3 were measured,and the molar ratio of IGF-1/IGFBP-3 was calculated.At the same time,247 healthy children(aged 0-13)in the Children’s Health Clinic of our hospital were selected as the control group,and the clinical data were collected.Concentrations of IGF-1 and IGFBP-3 were measured,and IGF-1/IGFBP-3 molar ratio was calculated.Results The concentration of IGF-1/IGFBP-3 molar ratio in short stature children was positively correlated with IGF-1(r=0.843,P<0.001).SDS of IGF-1/IGFBP-3 molar ratio was positively correlated with the SDS of IGF-1 concentration(r=0.773,P<0.001).During one year of rhGH treatment,IGF-1/IGFBP-3 molar ratio and IGF-1 concertration of SGA,GHD and ISS changed correspondingly,and the changing trend was the same,indicating that the IGF-1/IGFBP-3 molar ratio could also be a biomarker to evaluate the therapeutic effect of short stature rhGH.When the concentration of IGF-1 exceeded 2SDS,the molar ratio of IGF-1/IGFBP-3 was relatively stable,and no adverse events were observed,which indicated that the molar ratio of IGF-1/IGFBP-3 was reasonable in evaluating the safety of rhGH treatment.Conclusion The molar ratio of IGF-1/IGFBP-3 is a useful biomarker to evaluate the treatment of short stature rhGH.During the treatment of rhGH,the molar ratio of IGF-1/IGFBP-3 has certain scientific

关 键 词：矮身材 重组人生长激素 IGF-1 IGF-1/IGFBP-3摩尔比值 

分 类 号：Q575.11[生物学—生物化学]