Changes in " insulin-like growth factor-1-growth hormone" axis and insulin sensitivity in children with intrautherine growth retardation
Aim. To study the changes in the axis of the «growth hormone (GH) - insulin-like growth factor-1 (IGF-1)» and the insulin sensitivity of tissues in children born with IUGR, depending on the mass-height dynamics. Material and methods. 49 children born with IUGR and 30 control children born without IUGR were prospectively examined. Levels of GH and IGF-1 levels were determined in cord blood and estimation of the insulin sensitivity of tissues was carried out using the homeostatic model (HOMA-IR) at the age of 3 months. Results and discussion. Demonstrated that IGF-1levels in cord blood in children with IUGR in comparison with the control group was significantly lower, 52,20 (11,61-99,40) and 103,50 (46,17-181,99) ng/ml, respectively (p<0,05). There were no significant differences of growth hormone level in the umbilical cord blood between the groups. There were no significant differences of the level of IGF-1 and GH at the age of 3 months between the study and control groups. The values of basal insulin resistance of tissues (HOMA-IR) were significantly higher in children of study group: 1,12 (0,36-3,99) and 0,88 (0,21-1,64) ng/ml respectively (p<0,05). 16 of 23 children born with IUGR (69,5%) had «growth leap» in the first 3 months of life assessed by weight, and/or an increase of 2 or more centile corridor (CC). Accelerating the pace of growth was associated with significantly higher levels of IGF-1 and GH levels in 3 months of life. Conclusion. Revealed features of «GH-IGF-1» axis and insulin sensitivity of tissues in children with IUGR aimed to stimulation of postnatal growth and can predispose the development of carbohydrate metabolism disorders in later life.