Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy.
OBJECTIVE
To assess growth hormone (GH)/insulin like growth factor-1 (IGF-1) axis as a possible non-nutritional factor for growth retardation in children with cerebral palsy (CP).


METHODS
A case-control study was conducted at a tertiary university hospital. Thirty children with CP (seven children with normal growth [CP-N] and 23 with retarded growth [CP-R]), 30 children with protein energy malnutrition (PEM), and 30 healthy children (REF group) underwent an assessment of growth parameters, serum IGF-1, basal GH, and peak GH after stimulation with insulin.


RESULTS
PEM patients had higher basal GH levels than CP-N, CP-R and REF groups (p = 0.026, p < 0.001, and p < 0.001 respectively). After insulin stimulation, CP-N, CP-R, and PEM patients had lower GH levels compared to the REF group (p = 0.04, p = 0.007, and p = 0.036 respectively). IGF-1 levels were lower in CP-R group compared to CP-N and REF groups (p = 0.037 and p < 0.001 respectively), and in PEM group compared to CP-N and REF groups (p < 0.001 and p < 0.001 respectively).


CONCLUSIONS
CP-R patients failed to demonstrate the same high basal GH response as PEM patients, and responded inadequately to the insulin stimulation test, but they had IGF-1 levels comparable to those of PEM patients. On the other hand, CP-N patients behaved as controls regarding their basal GH and IGF-1 levels, but failed to respond adequately to the insulin stimulation test. The PEM group presented high basal GH and low IGF-1 levels. These findings suggest that non-nutritional factors contribute to growth retardation in CP children.
Department of Pediatrics, Mansoura University Children's Hospital, Mansoura University, Mansoura, Egypt. mhegazi712003@yahoo.co.uk
Moustafa A
MA
Hegazi
Othman E
OE
Soliman
Bothina M
BM
Hasaneen
Mohammed
M
El-Arman
Nawal Abd
NA
El-Galel
Basem S
BS
El-Deek
D001827:Body Height; D001835:Body Weight; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D016009:Chi-Square Distribution; D002149:Energy Intake; D005260:Female; D006130:Growth Disorders / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D020249:Hormone Replacement Therapy / Q000379:methods; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007223:Infant; D007328:Insulin / Q000008:administration & dosage; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D011502:Protein-Energy Malnutrition / Q000097:blood*; D018401:Sample Size; D018709:Statistics, Nonparametric
D007328:Insulin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I