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불현성 갑상샘 저하증 소아청소년의 IGF-I과 IGFBP-3를 이용한 성장 상태 평가

Evaluation of Growth Status Using Serum IGF-I and IGFBP-3 in Children with Subclinical Hypothyroidism

정소정|곽병옥|배재욱
대한소아내분비학회 (Korean Society Of Pediatric Endocrinology)|2011.04|Annals of Pediatric Endocrinology & Metabolism|제16권 제1호|pp. 31-37

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키워드

Hypothyroidism; Growth; Child
주제분류소아과학

초록

목 적:신체 계측과 IGF-I, IGFBP-3 측정을 통해 SCH 환자에서의 성장 상태를 알아보고자 하였다. 방 법:2005년 8월부터 2009년 6월까지 건국대학교병원 소아과에서 TSH, 유리 T4를 검사하였던 환자 중 불현성 갑상샘 기능저하로 확인된(TSH 4이상 10미만이고 유리 T4 1.8이하이면서 자가 갑상샘 항체 양성인 경우는 배제) 93명과 TSH와 유리 T4가 정상인 소아 94명을 대상으로 하였다. 연령은 평균 8.1세, 5세부터 11세 사이에 분포하였고 남아는 33명, 여아는 60명이었다. 신장과 체중, 체질량지수를 측정하고 각각의 Z-score를 구하였으며 채혈을 통해 IGF-I, IGFBP-3를 구하였다. 또한 각각의 성장 지표와 TSH, 유리 T4와의 상관관계를 구하였다. 결 과:불현성 갑상샘 기능저하 환아의 체중, 체질량지수는 대조군과 비교시 유의한 차이를 보였으나 신장 Z-score, 체중 Z-score, 체질량지수 Z-score 및 혈중 IGF-I and IGFBP-3 농도는 대조군과 비교시 유의한 차이를 보이지는 않았다. 불현성 갑상샘 기능저하 환아에서 TSH는 체중 Z-score (r=-0.23, P=0.028) 및 BMI Z-score (r=-0.21, P=0.048)와 유의한 음의 상관관계를 보였으며 유리 T4는 IGFBP-3와 유의한 상관관계가 있었다. 결 론:불현성 갑상샘 저하 환아에서 TSH의 증가는 성장지표 저하와 관계가 있으며 유리 T4의 증가 또한 성장인자와 관련되어 불현성 갑상샘 저하 환아에서도 성장저하 효과가 있음을 시사한다.

Abstract

Purpose:The aim of this study was to evaluate growth status using insulin-like growth factor-I (IGF-I) and IGF- binding protein-3 (IGFBP-3) concentrations in children with subclinical hypothyroidism (SCH). Methods:The study included 93 subclinical hypothyroidism (SCH) patients (33 males and 60 females, age 8.1±1.9 yrs) and 94 healthy control subjects (31 males and 63 females, age 8.0±0.7 yrs). Height and weight were measured and body mass index (BMI) and their Z-scores were calculated. The relationship between growth parameters including IGF-I and IGFBP-3 concentration and thyroid function (thyroid-stimulating hormone, TSH and free thyroxine 4, FT4) was explored. Results:Although weight and BMI were greater in SCH, Z-score of height, weight and BMI, and serum IGF-I and IGFBP-3 levels in SCH children were not significantly different compare to control. In SCH, TSH showed a negative correlation with weight Z-score (r=-0.23, P=0.028) and BMI Z-score (r=-0.21, P=0.048). FT4 showed a positive correlation with IGFBP-3. Conclusion:Positive correlation of fT4 and IGFBP-3 and negative relationship between TSH and weight Z-score and BMI Z-score in SCH children suggest that subnormal thyroid function could be related with growth impairment.(J Korean Soc Pediatr Endocrinol 2011;16:31-37)

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관련 논문AI추천

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