Publisher logo
Sign Up
Jordan Journal of Applied Science-Natural Science Series
Submit Manuscript
Applied Science Private University

Volume Volume 17, 2023 · Issue 1 · Open Access · Double-blind Peer-review

Submit an articleJournal homepage

Hypothesis

Insulin Growth Factor1 and Ghrelin's Relationship with the Nutritional Status of Children with Short Stature

Mohammed E. Moustafa1 & Ezz E. Khalifa2

1 Primary health care, Ministry of Health, Kuwait.

2 Primary health care, Ministry of Health, Egypt.

* Corresponding author: Mohammed E. Moustafa ([email protected])

Published: 30 Jun 2023

https://doi.org/10.35192/jjoas-n.v17i1.1809
Download PDF
Abstract

Background: Pediatricians often encounter issues related to short stature, particularly in underdeveloped nations. Changes in total ghrelin (TG) or acylated ghrelin (AG) are thought to influence growth by affecting growth hormone secretion, which may subsequently impact the formation of insulin-like growth factor-1 (IGF-1) or through alterations in hunger and food consumption.

Aim: This study aims to improve the management of children with short stature and assess the outcomes associated with it.

Methods: Between March 2021 and October 2022, a cross-sectional descriptive study was conducted at the pediatric endocrine clinic of Mahala General Hospital. The study enrolled 48 participants. The patients were divided into two groups: Group A included children with growth hormone deficiency, while Group B comprised children with unexplained short stature. Ghrelin levels, IGF-1, growth hormone, thyroxine, triiodothyronine, and thyroid-stimulating hormone were all measured.

Results: There was a statistically significant decrease in IGF-1 in Group A compared to Group B. Additionally, Group A exhibited significantly higher ghrelin levels than Group B. Growth hormone showed a statistically significant negative correlation with ghrelin and a positive correlation with IGF-1.

Conclusion: The relationship between growth hormone, IGF-1, and ghrelin is negative; the short stature group has a lower body mass index (BMI) than the growth hormone deficiency group, indicating a lower nutritional status. Ghrelin may be a contributing factor in the etiology of idiopathic short stature.

KeywordsGhrelinInsulin-like growth factor1NutritionShort stature

License

Journal License

This work is licensed under a Creative Commons Attribution 4.0 International license

References

  1. Polidori N, Castorani V, Mohn A, Chiarelli F. Deciphering short stature in children. Ann Pediatr Endocrinol Metab. 2020 Jun;25(2):69-79. doi: 10.6065/apem.2040064.032.
  2. Maghnie M, Labarta JI, Koledova E, Rohrer TR. Short Stature Diagnosis and Referral. Front Endocrinol (Lausanne). 2018 Jan 11;8:374. doi: 10.3389/fendo.2017.00374.
  3. Ranke MB. Short and Long-Term Effects of Growth Hormone in Children and Adolescents With GH Deficiency. Front Endocrinol (Lausanne). 2021 Sep 1;12:720419. doi: 10.3389/fendo.2021.720419.
  4. Yackobovitch-Gavan M, Gat-Yablonski G, Shtaif B, Hadani S, Abargil S, Phillip M, et al. Growth hormone therapy in children with idiopathic short stature - the effect on appetite and appetite-regulating hormones: a pilot study. Endocr Res. 2019 Feb-May;44(1-2):16-26. doi: 10.1080/07435800.2018.1493598.
  5. Lim HH, Kim YM, Lee GM, Yu J, Han HS, Yu J. Growth Responses During 3 Years of Growth Hormone Treatment in Children and Adolescents With Growth Hormone Deficiency: Comparison Between Idiopathic, Organic and Isolated Growth Hormone Deficiency, and Multiple Pituitary Hormone Deficiency. J Korean Med Sci. 2022 Mar 21;37(11):e90. doi: 10.3346/jkms.2022.37.e90.
  6. Claessen KM, Appelman-Dijkstra NM, Adoptie DM, Roelfsema F, Smit JW, Biermasz NR, et al. Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy. J Clin Endocrinol Metab. 2013 Jan;98(1):352-61. doi: 10.1210/jc.2012-2940.
  7. Iñiguez G, Román R, Youlton R, Cassorla F, Mericq V. Ghrelin plasma levels in patients with idiopathic short stature. Horm Res Paediatr. 2011 Feb;75(2):94-100. doi: 10.1159/000317429.
  8. Ibba A, Corrias F, Guzzetti C, Casula L, Salerno M, di Iorgi N, et al. IGF1 for the diagnosis of growth hormone deficiency in children and adolescents: a reappraisal. Endocr Connect. 2020 Nov;9(11):1095-1102. doi: 10.1530/EC-20-0347.
  9. Zhou G, Du R. Dynamic Ghrelin and GH serum levels during combined simultaneous arginine clonidine stimulation test in children with dwarfism. Ital J Pediatr. 2019 Jan 28;45(1):17. doi: 10.1186/s13052-019-0610-5.
  10. Stawerska R, Czkwianianc E, Smyczyńska J, Hilczer M, Lewiński A. Nutritional Status in Short Stature Children Is Related to Both Ghrelin and Insulin-like Growth Factor I Concentrations. J Pediatr Gastroenterol Nutr. 2017 May;64(5):812-817. doi: 10.1097/MPG.0000000000001387.
  11. Zhang Z, Li F, Hannon BA, Hustead DS, Aw MM, Liu Z, et al. Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis. Nutrients. 2021 Aug 30;13(9):3036. doi: 10.3390/nu13093036.
  12. Young AA. Brainstem sensing of meal-related signals in energy homeostasis. Neuropharmacology. 2012;63(1):31-45. doi: 10.1016/j.neuropharm.2012.03.019.
  13. Ibrahim Abdalla MM. Ghrelin - Physiological Functions and Regulation. Eur Endocrinol. 2015 Aug;11(2):90-95. doi: 10.17925/EE.2015.11.02.90.
  14. Kanakis GA, Chrisoulidou A, Bargiota A, Efstathiadou ZA, Papanastasiou L, Theodoropoulou A, et al. The ongoing challenge of discrepant growth hormone and insulin-like growth factor I results in the evaluation of treated acromegalic patients: a systematic review and meta-analysis. Clin Endocrinol (Oxf). 2016 Nov;85(5):681-688. doi: 10.1111/cen.13129.
  15. Hamza RT, Ismail MA, Hamed AI. Growth hormone deficiency in children and adolescents with cerebral palsy: relation to gross motor function and degree of spasticity. Pak J Biol Sci. 2011 Apr 1;14(7):433-40. doi: 10.3923/pjbs.2011.433.440.
  16. Cohen LE. Idiopathic short stature: a clinical review. JAMA. 2014 May 7;311(17):1787-96. doi: 10.1001/jama.2014.3970.
  17. Smyczyńska J, Stawerska R, Lewiński A, Hilczer M. Do IGF-I concentrations better reflect growth hormone (GH) action in children with short stature than the results of GH stimulating tests? Evidence from the simultaneous assessment of thyroid function. Thyroid Res. 2011 Jan 13;4(1):6. doi: 10.1186/1756-6614-4-6.
  18. Amin MK, Ahmed HG, Selmy M, Gad SS. Correlation of body mass index to Ghrelin and IGF-1 among children with short stature. J Pediatr (Rio J). 2022 May-Jun;98(3):276-281. doi: 10.1016/j.jped.2021.04.012.
  19. Stawerska R, Szałapska M, Hilczer M, Lewiński A. Ghrelin, insulin-like growth factor I and adipocytokines concentrations in born small for gestational age prepubertal children after the catch-up growth. J Pediatr Endocrinol Metab. 2016 Aug 1;29(8):939-45. doi: 10.1515/jpem-2015-0463.
  20. Patro-Małysza J, Trojnar M, Skórzyńska-Dziduszko KE, Kimber-Trojnar Ż, Darmochwał-Kolarz D, Czuba M, et al. Leptin and Ghrelin in Excessive Gestational Weight Gain-Association between Mothers and Offspring. Int J Mol Sci. 2019 May 15;20(10):2398. doi: 10.3390/ijms20102398.
  21. Hajishizari S, Imani H, Mehranfar S, Saeed Yekaninejad M, Mirzababaei A, et al. The association of appetite and hormones (leptin, ghrelin, and Insulin) with resting metabolic rate in overweight/ obese women: a case-control study. BMC Nutr. 2022 Apr 29;8(1):37. doi: 10.1186/s40795-022-00531-w.
  22. Lewiński A, Karbownik-Lewińska M, Wieczorek-Szukała K, Stasiak M, Stawerska R. Contribution of Ghrelin to the Pathogenesis of Growth Hormone Deficiency. Int J Mol Sci. 2021 Aug 23;22(16):9066. doi: 10.3390/ijms22169066.
  23. Willaschek C, Meint S, Rager K, Buchhorn R. Modified Clonidine Testing for Growth Hormone Stimulation Reveals α2-Adrenoreceptor Sub Sensitivity in Children with Idiopathic Growth Hormone Deficiency. PLoS One. 2015 Sep 11;10(9):e0137643. doi: 10.1371/journal.pone.0137643.
  24. Terra X, Auguet T, Agüera Z, Quesada IM, Orellana-Gavaldà JM, Aguilar C, et al. Adipocytokine levels in women with anorexia nervosa. Relationship with weight restoration and disease duration. Int J Eat Disord. 2013 Dec;46(8):855-61. doi: 10.1002/eat.22166.
  25.  Witkowska-Sędek E, Kucharska AM, Rumińska M, Paluchowska M, Pyrżak B. Decreased Thyroxine Levels during rhGH Therapy in Children with Growth Hormone Deficiency. J Clin Med. 2021 Oct 30;10(21):5100. doi: 10.3390/jcm10215100.
  26. Ranke MB. Short and Long-Term Effects of Growth Hormone in Children and Adolescents With GH Deficiency. Front Endocrinol (Lausanne). 2021 Sep 1;12:720419. doi: 10.3389/fendo.2021.720419.
  27. Fittipaldi AS, Hernández J, Castrogiovanni D, Lufrano D, De Francesco PN, Garrido V, et al. Plasma levels of ghrelin, des-acyl ghrelin and LEAP2 in children with obesity: correlation with age and insulin resistance. Eur J Endocrinol. 2020 Feb;182(2):165-175. doi: 10.1530/EJE-19-0684.
  28.  Devesa J. The Complex World of Regulation of Pituitary Growth Hormone Secretion: The Role of Ghrelin, Klotho, and Nesfatins in It. Front Endocrinol (Lausanne). 2021 Mar 11;12:636403. doi: 10.3389/fendo.2021.636403.
  29. Serrenho D, Santos SD, Carvalho AL. The Role of Ghrelin in Regulating Synaptic Function and Plasticity of Feeding-Associated Circuits. Front Cell Neurosci. 2019 May 27;13:205. doi: 10.3389/fncel.2019.00205.
  30.  Wit JM, Joustra SD, Losekoot M, van Duyvenvoorde HA, de Bruin C. Differential Diagnosis of the Short IGF-I-Deficient Child with Apparently Normal Growth Hormone Secretion. Horm Res Paediatr. 2021;94(3-4):81-104. doi: 10.1159/000516407.