| ObjectiveThe congenital hypothyroidism (CH) is one of Pediatric Endocrinology disease, and thyroid hormone replacement therapy is now the best choice for the children. The neuropsychological developments of the some child accepted early diagnosis and treatment were varied in different degree such as perception, motion, mind, learning, memory, speech and so on. Insulin-like growth factor binding protein-3 (IGFBP-3) was a kind of active-polypeptide with lots of physiological functions. IGFBP-3 plays an important role in growth and development, and has the effect on the function and growth of thyroid gland.The effect of IGFBP-3 levels in the children with CH on the physical growth and intelligence development was examined in our data in order to provide a new way for the integrated treatment and to improve the growth and development of the children.Methods1. Grouping:①the case group was the 42 children with CH diagnosed by the newborn diseases screening central.②the normal group was 41healthy children, with 1:1 matching the case group as the age and sex.2. The choose criteria:All children have no premature infant, asphyxia, hypoxic encephalopathy,function lesion of liver and kidney, function lesion of heart, but the thyroid hormones levels had to be in normal at the present time.3. The inform consents: the book of inform consents was written by the parents in our data.4. The content inquisition: The children's parents were investigated with the self-designed questionnaire included general situation, growth and development of the children, and so on.5. The determination index: the height and weight of all children were measured and their levels of growth and development were evaluated. The intelligence development levels was determined in 2～years children with CDCC and in 3～7 years children with C-WYCSI, respectively. The content of IGFBP-3 in venous blood was tested with immunoradiometric assay (IRMA).6. The data analysis: Our data were statistically analyzed with the Statistical Package for Social Sciences (SPSS 16.0).Results1. General status:(1) In the age, living environment, mode of labor, infant feeding way in the first three months, early education there were no significant difference between case group and normal group (the X2 value was 0.675, 5.291, 0.775, 0.448, 2.707 respectively, p>0.05).(2) In the birth weight, the beginning month of climb and walking independently, the month of tooth eruption, the child-bearing age of the mother, the period of operated computer in pregnancy and care baby there were no significant difference between case group and normal group (the t value was 0.885, 0.59, 0.113, 1.499, 0.165, 0.836, 1.909, respectively, p>0.05).(3) The incidences of jaundice of newborn in the normal group were lower than that in case group (the X2 value was 4.943, p<0.05).2. Status of physical development:The standard deviation score (SDS) of weight and height, and the body mass index (BMI) in case group and normal group were no significant difference (the t value was 1.122, 0.065, 1.628, respectively, p>0.05).3. Status of intelligence:(1)In the 2～years children, the mental development index (MDI) in the case group was significant lower than that in the normal group (t=2.423,p<0.05). but the physical development index (PDI) there were no statistically difference between the normal group and the case group (t=1.92, p>0.05).(2)In 3～7 years children, the ability of cognitive language, levels of memory and operative ability in the case group were significant lower than that in the normal group(the t value was 6.038, 3.404, 2.647 respectively, p<0.05), but there was no statistically difference in speed of reaction between the two groups (the t value in language item and in operation item was 0.484, 0.893 respectively, p>0.05).(3)The rate of∣V-P∣≥14 in 3～7 years children, there was significant higher in the case group than that in normal group (X2=6.28, p<0.05), and the IGFBP-3 levels of in the children with∣V-P∣≥14 was significant lower than that in the children with∣V-P∣<14 (t=2.057, p<0.05).4. The levels of IGFBP-3:(1) The levels of IGFBP-3 in the childrenIn the 2～years group, the levels of IGFBP-3 in the case group and the normal group was no statistically difference (t=1.54, p>0.05). In the 3～7 years group, the concentration of IGFBP-3 in the case group was significant lower than that in the normal group(t=2.997, p<0.05).(2) Relationship between levels of IGFBP-3 and physical developmentIn 3～7 years children there was positive relationship between the IGFBP-3 concentration and the weight, and the height (the correlation coefficient was 0.315, 0.296, respectively, p<0.05). However, in 2～years children there was no difference between the concentration of IGFBP-3 and the weight, and the height(the correlation coefficient was 0.276, 0.082, respectively, p>0.05).(3) Relationship between levels of IGFBP-3 and intelligence developmentIn 2～years children, there were no significant relationship between IGFBP-3 levels and MDI, and PDI (the correlation coefficient was 0.261, 0.131, respectively, (p>0.05). In 3～7 years children there were significant positive relationship between IGFBP-3 and Full Intelligence Quotient (FIQ), and Verbal Intelligence Quotient (VIQ), and the finish time of VIQ (the correlation coefficient was 0.285, 0.303, 0.268, respectively, p<0.05), but no significant positive relationship between IGFBP-3 and Performance Intelligence Quotient (PIQ), r was 0.183, p>0.05.(4)Multivariate gradually regression analysisIn 3～7 years children between the concentration of IGFBP-3 and the scores tested with C-WYCSI there were positive relationship between the IGFBP-3 levels and knowledge, and the picture vocabulary, and the visual program, and the memory inverse order (the correlation coefficient was 0.252, 0.474, 0.251,0.317, respectively, p<0.05). However, there was no significant relationship between the levels of IGFBP-3 and the arithmetic, and the picture summarize, and the understanding, and the program of lay eggs, and the picture packed, and the maze, and the block pattern, and the memory in order (the correlation coefficient was 0.241, 0.158, 0.170, 0.178, 0.217, 0.078, 0.031, 0.206, respectively, p>0.05). With the multivariate gradually regression analysis, the IGFBP-3 for the dependent variable and each testing scores of C-WYCSI for independent variable, suggested that the first chief six factors were picture vocabulary, understanding, memory inverse order, maze and visual analysis. The regression equation, X for picture vocabulary and Y for the concentrations of IGFBP-3, was Y=720.991+135.24X.Conclusion1. There were the deficits of cognition ability still in the children with CH, although the children can not been in the physical and mental retardation when having accepted the early diagnosis and therapy.2. The cut-point of the"∣V-P∣≥14"in C-WYCSI is an important index for the balance development of intelligence.3. The decrease of IGFBP-3 is one of impaired feature for the children with CH, when the imbalance development of the VIQ and PIQ, especially when in the ability decrease in the cognition and the verbal.4. The IGFBP-3 levels of children with CH was still lower than that in the normal children although having accepted the early treatment. 5. There were positive relationship between the IGFBP-3 concentration and IQ, and the weight, and the height.6. The chief indexes, the influence IQ development in the C-WYCSI, were picture vocabulary, understanding, memory inverse order, maze, visual analysis and memory in order, that can play an important role in the children's education. |
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