Abstract
Insulin-like growth factor (IGF-1) concentrations were determined in a series of 23 children with juvenile chronic arthritis in conjunction with anthropometric assessment. When standardised z scores were used significant decreases in height and weight were shown in comparison with the normal age/sex matched means. Severe growth disturbance was seen, particularly in those with prolonged disease duration, which was independent of corticosteroid treatment, indicating disease activity itself is a major factor in the growth retardation. Eight children had low IGF-1 z scores--that is, less than -2.00 from age/sex matched mean. Low IGF-1 z scores were associated with low weight z scores but not with low height z scores. Overnight growth hormone secretory profiles were determined in 10 patients, including seven with low IGF-1, and showed generally normal secretion in all but one patient, who subsequently attained normal concentrations coincident with catch up growth. Increased pulse frequency of overnight secretion was commonly seen. Low IGF-1 concentrations probably result from varying factors, particularly nutritional, but do not reflect marked endocrinological abnormalities in most patients.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ansell B. M., Bywaters E. G. Alternate-day corticosteroid therapy in juvenile chronic polyarthritis. J Rheumatol. 1974 Jun;1(2):176–186. [PubMed] [Google Scholar]
- Ansell B. M. Heberden Oration, 1977. Chronic arthritis in childhood. Ann Rheum Dis. 1978 Apr;37(2):107–120. doi: 10.1136/ard.37.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bercu B. B., Diamond F. B., Jr A determinant of stature: regulation of growth hormone secretion. Adv Pediatr. 1986;33:331–380. [PubMed] [Google Scholar]
- Butenandt O., Kelch A., Rajmann E. Growth hormone studies in patients with rheumatoid arthritis with or without glucocorticoid therapy. Z Kinderheilkd. 1974;118(1):53–62. doi: 10.1007/BF00506053. [DOI] [PubMed] [Google Scholar]
- Butenandt O. Rheumatoid arthritis and growth retardation in children: treatment with human growth hormone. Eur J Pediatr. 1979 Jan 18;130(1):15–28. doi: 10.1007/BF00441894. [DOI] [PubMed] [Google Scholar]
- Dibley M. J., Staehling N., Nieburg P., Trowbridge F. L. Interpretation of Z-score anthropometric indicators derived from the international growth reference. Am J Clin Nutr. 1987 Nov;46(5):749–762. doi: 10.1093/ajcn/46.5.749. [DOI] [PubMed] [Google Scholar]
- Donaldson D. L., Hollowell J. G., Pan F. P., Gifford R. A., Moore W. V. Growth hormone secretory profiles: variation on consecutive nights. J Pediatr. 1989 Jul;115(1):51–56. doi: 10.1016/s0022-3476(89)80328-2. [DOI] [PubMed] [Google Scholar]
- Hintz R. L., Suskind R., Amatayakul K., Thanangkul O., Olson R. Plasma somatomedin and growth hormone values in children with protein-calorie malnutrition. J Pediatr. 1978 Jan;92(1):153–156. doi: 10.1016/s0022-3476(78)80099-7. [DOI] [PubMed] [Google Scholar]
- Kirk J. A., Raghupathy P., Stevens M. M., Cowell C. T., Menser M. A., Bergin M., Tink A., Vines R. H., Silink M. Growth failure and growth-hormone deficiency after treatment for acute lymphoblastic leukaemia. Lancet. 1987 Jan 24;1(8526):190–193. doi: 10.1016/s0140-6736(87)90004-3. [DOI] [PubMed] [Google Scholar]
- Kirschner B. S., Sutton M. M. Somatomedin-C levels in growth-impaired children and adolescents with chronic inflammatory bowel disease. Gastroenterology. 1986 Oct;91(4):830–836. doi: 10.1016/0016-5085(86)90683-9. [DOI] [PubMed] [Google Scholar]
- Lin T. H., Kirkland R. T., Sherman B. M., Kirkland J. L. Growth hormone testing in short children and their response to growth hormone therapy. J Pediatr. 1989 Jul;115(1):57–63. doi: 10.1016/s0022-3476(89)80329-4. [DOI] [PubMed] [Google Scholar]
- Merriam G. R., Wachter K. W. Algorithms for the study of episodic hormone secretion. Am J Physiol. 1982 Oct;243(4):E310–E318. doi: 10.1152/ajpendo.1982.243.4.E310. [DOI] [PubMed] [Google Scholar]
- Spencer E. M., Uthne K. O., Arnold W. C. Growth impairment with elevated somatomedin levels in children with chronic renal insufficiency. Acta Endocrinol (Copenh) 1979 May;91(1):36–48. doi: 10.1530/acta.0.0910036. [DOI] [PubMed] [Google Scholar]
- Spiliotis B. E., August G. P., Hung W., Sonis W., Mendelson W., Bercu B. B. Growth hormone neurosecretory dysfunction. A treatable cause of short stature. JAMA. 1984 May 4;251(17):2223–2230. [PubMed] [Google Scholar]
- Sturge R. A., Beardwell C., Hartog M., Wright D., Ansell B. M. Cortisol and growth hormone secretion in relation to linear growth: patients with Still's disease on different therapeutic regimens. Br Med J. 1970 Sep 5;3(5722):547–551. doi: 10.1136/bmj.3.5722.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Takami M., Taguchi T., Nagashima K. [Endocrinological studies on growth retardation in children with juvenile rheumatoid arthritis (author's transl)]. Ryumachi. 1982 Feb;22(1):14–19. [PubMed] [Google Scholar]
- Werther G. A., Matthews R., Burger H. G., Herington A. C. Deficiency of non-suppressible insulin-like activity in thalassaemia major. Arch Dis Child. 1981 Nov;56(11):855–859. doi: 10.1136/adc.56.11.855. [DOI] [PMC free article] [PubMed] [Google Scholar]