An Evaluation of Growth Hormone and IGF-1 Responses in Neonates with Hyperinsulinaemic Hypoglycaemia
An Evaluation of Growth Hormone and IGF-1 Responses in Neonates with Hyperinsulinaemic Hypoglycaemia
复制标题
高胰岛素低血糖新生儿生长激素和 IGF-1 反应的评估
DOI：
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发表时间：
2013
影响因子：
2.8
通讯作者：
K. Hussain
中科院分区：
文献类型：
--
作者：
S. Senniappan;K. Hussain
背景。高胰岛素性低血糖（HH）是新生儿期严重和持续低血糖的最常见原因。已有研究表明，患有HH的新生儿对症状性低血糖不能产生足够的血清皮质醇反调节反应。然而，生长激素（GH）和胰岛素样生长因子1 （IGF-1）在其中的作用尚不清楚。目标。比较诊断性禁食研究中新生儿血清GH、IGF-1和IGFBP3对HH的反应。人口与方法。资料是回顾性收集的足月新生儿谁提出了严重和持续低血糖，并证实有HH。排除宫内生长迟缓或正在接受药物治疗（二氮卓或奥曲肽）的新生儿。结果：31例HH新生儿（平均胎龄：38周，平均出生体重：3.9 kg）纳入研究。诊断禁食时的平均年龄为4周，禁食期间的平均葡萄糖浓度为2.2 mmol/L (SEM±0.09)，平均胰岛素水平为11.9 mU/L（±2.12）。低血糖期间的平均血清GH浓度为12.5µg/L（±1.53）。血清IGF-1和胰岛素样生长因子结合蛋白3 （IGFBP3）平均水平分别为29.2 ng/ml（±7.8）和1.21 mg/L（±0.13）。皮质醇平均浓度201 nmol/L（±33）。结论。虽然低血糖时血清IGF-1和IGFBP3水平相对较低，但血清GH水平确实反映了对HH的适当反调节反应。血清皮质醇反调节激素反应减弱。需要进一步的研究来了解HH新生儿中这些激素改变的机制。
Background. Hyperinsulinaemic Hypoglycaemia (HH) is the most common cause of severe and persistent hypoglycemia in the neonatal period. It has been shown that the neonates with HH fail to generate adequate serum cortisol counterregulatory response to symptomatic hypoglycemia. However the role played by growth hormone (GH) and Insulin-like Growth Factor 1 (IGF-1) is not clear. Objectives. To compare the serum GH, IGF-1, and IGFBP3 responses to HH in neonates undergoing diagnostic fasting studies. Population and Methods. Data was retrospectively collected on full-term neonates who presented with severe and persistent hypoglycemia and were confirmed to have HH. Neonates born with intrauterine growth retardation or those on medical therapy (diazoxide or octreotide) were excluded. Results. 31 neonates with HH (mean gestational age: 38 weeks and mean birth weight: 3.9 kg) were included in the study. The mean age at the time of diagnostic fast was 4 weeks, the mean glucose concentration during the fast was 2.2 mmol/L (SEM ± 0.09), and the mean insulin level was 11.9 mU/L (±2.12). The mean serum GH concentration during the hypoglycaemia was 12.5 µg/L (±1.53). The mean serum IGF-1 and Insulin-like Growth Factor Binding Protein 3 (IGFBP3) levels were 29.2 ng/ml (±7.8) and 1.21 mg/L (±0.13), respectively. The mean cortisol concentration was 201 nmol/L (±33). Conclusions. Whilst the serum IGF-1 and IGFBP3 levels are relatively low during hypoglycaemia, the serum GH level does reflect an appropriate counterregulatory response to HH. The serum cortisol counterregulatory hormonal responses are blunted. Further studies are required to understand the mechanism(s) of these hormonal alterations in neonates with HH.
DOI：
10.1210/jcem-51-4-877
发表时间：
1980-10
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Julio V. Santiago;William L. Clarke;Suresh D. Shah;Philip E. Cryer
通讯作者：
Julio V. Santiago;William L. Clarke;Suresh D. Shah;Philip E. Cryer
影响因子：
3.5
作者：
Thomas, P;Ye, YY;Lightner, E
通讯作者：
Lightner, E