摘要
目的检测矮小儿童血浆ghrelin及生长激素结合蛋白(GHBP)水平变化,探讨其在矮小儿童生长发育中的作用。方法收集就诊的矮小儿童70例,根据生长激素刺激试验GH峰值<7ng/ml、7～10ng/ml、>10ng/ml分为生长激素缺乏组1(GHD1,20例)、生长激素缺乏组2(GHD2,20例)及特发性矮小组(ISS,30例);抽取20例年龄、性别相匹配的正常身高儿童作为对照组。对其进行全面的病史采集和体格检查,并检测血浆ghrelin及血清GHBP水平。采用方差分析、卡方检验及多元回归分析等统计学方法对结果进行分析。结果GHD1组血浆ghrelin水平低于其余三组[(4.21±2.70)ng/ml对(6.12±2.16)ng/ml、(6.20±2.75)ng/ml、(5.11±2.53)ng/ml,P均<0.05];GHD2组与ISS组血浆ghrelin水平近似,高于正常对照组[(6.12±2.16)ng/ml、(6.20±2.75)ng/ml对(5.11±2.53)ng/ml,P<0.05)]。对ghrelin进行多重线性回归分析得出体重为ghrelin的独立影响因素(β=-188.46,P<0.0001)。GHD1组血清GHBP水平与正常对照组差异无统计学意义[(3869.6±702.1)pmol/ml对(4192.9±1043.5)pmol/ml,P>0.05)];GHD2组与ISS组血清GHBP水平近似,均低于正常对照组[(3584.2±469.5)pmol/ml、(3443.5±568.4)pmol/ml对(4192.9±1043.5)pmol/ml,P<0.05)]。结论血浆ghrelin在不同的矮小症中所扮角色不同,GH峰值<7ng/ml中为病因之一;而GH峰值>7ng/ml的矮小症中为对低体质量的适应性代偿。ISS及GHD2组血清GHBP水平低下,提示这两组中存在生长激素受体(GHR)突变。
Objective To monitor plasma level of ghrelin and serum level of growth hormone binding protein （GHBP） in short stature children and explore their roles on growth. Methods Seventy short stature children and 20 agematched healthy children were recruited in the study. The short stature children were divided into 3 sub-groups according to the peak value of growth hormone （GH） stimulation test, growth hormone deficiency 1 group （GHD1） （GH 〈 7 ng/ml） （20 patients）, GHD2 group （GH = 7 - 10 ng/ml） （20 patients）, and idiopathic short stature group （ISS） （GH 〉 10 ng/ml） （30 patients）. All their detailed medical history and records of physical examination were collected. Serum level of growth hormone binding protein （GHBP） and plasma level of ghrelin were measured. The results were analyzed by X2-test, one-way ANOVA and multiple regression analyses. Results The level of plasma ghrelin was lower in GHD1 group than that in other three groups （（4.21 ± 2.70） ng/ml vs （6.12 ± 2.16） ng/ml, （6.20 ± 2.75） ng/ml, （5.11 ±2.53） ng/ml, all P 〈 0.05 ）. Plasma ghrelin was similar in GHD2 and ISS groups, higher than that of control group （ 6.12 ± 2.16） ng/ml, （6.20 ± 2.75） ng/ml vs （5.11 ± 2.53） ng/ml, respectively, P 〈 0.05）. Multiple regression analyses showed that weight was the independent determinant of ghrelin （β = -188.46, P 〈 0.000 1 ）. The level of serum GHBP was similar in GHD2 and ISS groups, lower than that of control group （ （3 584.2 ± 469.5） pmol/ml, （3 443.5±568.4） pmol/ml vs （4 192.9 ± 1 043.5） pmol/ml, respectively, P 〈 0.05）. There was no statistical difference in GHBP between GHDI and control groups （（3 869.6± 702.1） pmol/ml vs （4 192.9± 1 043.5） pmol/ml, P 〉 0.05）. Conlusions Ghrelin played a role as a cause in GHD1 group, while it was a compensatory mechanism to lowered body weight in the group with GH 〉 7 ng/ml in the GH provocative tests. Serum GHBP was lower in GHD2 and ISS groups, suggesting possible mutation of the growth hormone receptor.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2009年第12期1118-1121,共4页
Journal of Clinical Pediatrics
基金
苏州科技发展基金(No.SSY0629)
