[tri-med] FYI - IUGR

I am forwarding this article or URL for your information (FYI) as I believe
it may be of interest and is from a reliable source. As always, check the
information with your own doctor or health care professional before starting
or changing any treatments.

Pediatric Research 51:94-99 (2002)
© 2002 International Pediatric Research Foundation, Inc.

Growth, IGF System, and Cortisol in Children with Intrauterine Growth 
Retardation: Is Catch-up Growth Affected by Reprogramming of
the Hypothalamic-Pituitary-Adrenal Axis?
STEFANO CIANFARANI, CATERINA GEREMIA, CAROLYN D. SCOTT and DANIELA GERMANI
Laboratory of Pediatric Endocrinology, Department of Pediatrics, 'Tor Vergata' 
University, 00133 Rome, Italy [S.C., C.G., D.G.]; and
the Kolling Institute of Medical Research, University of Sydney, St. Leonards, 
New South Wales 2065, Australia [C.D.S.]

Correspondence and reprint requests: Stefano Cianfarani, M.D., Laboratory of 
Pediatric Endocrinology, Room E-178, 'Tor Vergata'
University, via di Tor Vergata 135, 00133, Rome, Italy; e-mail. 
stefano.cianfarani@xxxxxxxxxxx

Intrauterine growth retardation (IUGR) is one of the major causes of short 
stature in childhood. Although postnatal catch-up growth
occurs in the majority of IUGR children, approximately 20% of them remain 
permanently short. The mechanisms that allow catch-up
growth or, on the contrary, prevent IUGR children from achieving a normal 
height are still unknown. Our aim was to investigate
whether intrauterine reprogramming of hypothalamic-pituitary-adrenal axis may 
be involved in postnatal growth retardation of IUGR
children through a modulation of the function of the IGF system. Anthropometry, 
IGF system assessment, cortisol measurement, and
lipid profile evaluation were performed in 49 IUGR children. Children were 
subdivided into two groups according to their actual
height corrected for midparental height: CG (catch-up growth) group, 19 
children with corrected height 0 z-score; and NCG
(noncatch-up growth) group, 30 subjects with corrected height <0 z-score. CG 
children showed significantly higher birth weight (p <
0.005) and body mass index (p < 0.05). No significant differences in IGF-I, 
IGF-II, IGF binding protein (IGFBP)-1, IGFBP-3, soluble
IGF-II receptor levels (IGF2R), IGF-II/IGF2R ratio, and relative amounts of 
IGFBP-3 circulating forms were found between CG and NCG
children. None of the IGF system-related variables correlated with 
anthropometric indices. NCG children showed significantly higher
concentrations of cortisol (p < 0.005) and cortisol levels resulted inversely 
to birth weigh (r = -0.34, p < 0.05), birth length (r
= -0.36, p < 0.05), and corrected height (r = -0.44, p < 0.01). Whereas total 
and HDL cholesterol concentrations were not
significantly different in the two groups, LDL cholesterol levels were 
significantly higher in NCG children (p < 0.05), and five of
49 showed LDL cholesterol concentrations >3.4 mM (130 mg/dL). LDL cholesterol 
was inversely related to birth weight (r = -0.31, p <
0.05), corrected stature (r = -0.32, p < 0.05), and actual height (r = -0.31, p 
< 0.05) and directly related to the levels of IGF2R
(r = 0.44, p < 0.01). Reanalysis of 15 of 30 IUGR newborns in whom we 
previously reported an inverse relationship between cord blood
cortisol levels and first trimester length gain (r = -0.54, p < 0.005) showed 
that the relative amount of the IGFBP-3 18-kD fragment
was related inversely to cortisol (r = -0.67, p < 0.01) and directly to early 
postnatal growth (r = 0.65, p < 0.05). Our results
suggest that catch-up growth in IUGR children might be affected by intrauterine 
reprogramming of hypothalamic-pituitary-adrenal
axis, which may result in a permanent modification of the neuroendocrine 
response to stress: children with increased cortisol
secretion may be at higher risk of growth failure. During the neonatal period 
cortisol might act by limiting IGFBP-3 proteolysis
and, therefore, reducing IGF bioavailability.


Abbreviations:
CG, catch-up growth
HPAA, hypothalamic-pituitary-adrenal axis
IGF2R, soluble IGF-II/mannose-6-phosphate receptor
IUGR, intrauterine growth retardation
MPH, midparental height
NCG, noncatch-up growth
IGFBP, IGF binding protein
CV, coefficient of variation


                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

Other related posts: