Objective: It can be challenging to determine the correct dosage of recombinant growth hormone (GH) in children with GH deficiency, leading to highly variable treatment responses. Insulin-like growth factor-1 (IGF-1) is a tool for monitoring GH treatment and dosing. However, IGF-1 levels depend on sex, age, and pubertal stage, amongst other factors, making its interpretation somewhat difficult. This study aimed to evaluate descriptively a group of 93 children treated per protocol with GH to assess the influence of pubertal signs and sex steroid levels on the interpretation of IGF-1.
Methods: 93 (67 boys and 26 girls) prepubertal children who participated in a previous GH treatment trial were included. Age, pubertal stage, weight, height, GH dose, and IGF-1 plasma concentrations were collected at least yearly from 2 years before pubertal start and 3 years after pubertal start. Levels of estradiol in girls and testosterone in boys were analyzed from previously collected frozen samples.
Results: Nine of 58 (15.5%) estradiol samples in girls with Tanner breast stage 1 had pubertal levels of estradiol ≥25 pmol/L. For boys with testes size <4 mL, 24 out of the 153 (15.7%) testosterone samples were above the pubertal cut-off, ≥0.47 nmol/L. All the IGF-1 samples were divided into two groups based on an IGF-1 standard deviation score (SDS) of ≥2 or <2 SDS. The IGF-1 ≥2 SDS samples had a higher median (range) GH dose, 0.042 (0.02-0.10) mg/kg/day, compared with the IGF-1 <2 SDS samples, 0.038 (0.01-0.10) mg/kg/day, p<0.001. In the IGF-1 ≥2 SDS samples vs the IGF <2 SDS samples, estradiol levels were lower among girls, 13 (3-214) vs 102 (1-1070) pmol/L p<0.001, and testosterone levels were lower among boys, 0.35 (0.11-27.2) vs 6.9 (0.04-31.2) nmol/L p<0.001.
Conclusion: Interpretation of IGF-1 near puberty is challenging due to the influence of sex steroids. Variations in sex steroid levels and pubertal status can lead to misleading interpretations and an overestimation of IGF-1 SDS. Establishing an IGF-1 reference range that includes sex steroid levels can improve its clinical use to monitor GH treatment.
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http://dx.doi.org/10.3389/fendo.2024.1514935 | DOI Listing |
Pediatr Dermatol
March 2025
Department of Dermatology, Ankara Etlik City Hospital, Ankara, Turkey.
Anagen effluvium is a rare adverse effect of methotrexate therapy, generally associated with high-dose regimens. We report a 12-year-old girl who developed abrupt hair loss 1 week after inadvertently taking methotrexate 15 mg daily for five consecutive days (total 75 mg), without other signs of systemic toxicity. Trichoscopic examination and trichogram findings confirmed methotrexate-induced anagen effluvium, and spontaneous hair regrowth occurred after 2 months.
View Article and Find Full Text PDFEpidemiol Psychiatr Sci
March 2025
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Aims: To examine the risk of perinatal mental illness, including new diagnoses and recurrent use of mental healthcare, comparing women with and without traumatic brain injury (TBI), and to identify injury-related factors associated with these outcomes among women with TBI.
Methods: We conducted a population-based cohort study in Ontario, Canada, of all obstetrical deliveries to women in 2012-2021, excluding those with mental healthcare use in the year before conception. The cohort was stratified into women with no remote mental illness history (to identify new mental illness diagnoses between conception and 365 days postpartum) and those with a remote mental illness history (to identify recurrent illnesses).
Front Pediatr
February 2025
Department of Urology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Perinatal testicular torsion is not common in clinic. We report our experience in treating such a condition in a 50-day boy with an intraperitoneal mass. The clinical manifestations, physical examination, imaging examination and treatment of the boy were retrospectively analyzed and the related literatures were reviewed.
View Article and Find Full Text PDFFront Immunol
March 2025
Department of Reproductive Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital of Sichuan University, Chengdu, China.
Extracellular vesicles (EVs), as cell-derived small vesicles, facilitate intercellular communication within the tumor microenvironment (TME) by transporting biomolecules. EVs from different sources have varied contents, demonstrating differentiated functions that can either promote or inhibit cancer progression. Thus, regulating the formation, secretion, and intake of EVs becomes a new strategy for cancer intervention.
View Article and Find Full Text PDFBackground And Aims: Alzheimer's disease (AD) is a widespread neurodegenerative condition that has a growing impact on a global scale. This study aims to examine the relationship between cerebral blood flow (CBF) and the synaptic biomarker growth-associated protein 43 (GAP-43) through the utilization of arterial spin labeling (ASL). The research identified noteworthy correlations between cerebrospinal fluid (CSF) GAP-43 levels, CBF, and cognitive composite scores, especially among participants with mild cognitive impairment (MCI) who possess the APOE-ε4 gene.
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