Changes Of Serum Ghrelin And Nesfatin-1 In Children With Growth Hormone Deficiency Based On Recombinant Human Growth Hormone Therapy

Objective:GHD,one of the major causes of short stature in children is a disorder of growth and development,resulting from the disorder of the GH molecular structure.receptor abnormalities,or partial or complete lack of growth hormone(GH)secretion or synthesis.Ghrelin,an endogenous ligand for the somatotrop in-releasing hormone receptor,promotes the release of growth hormone.Nesfatin-1 is a newly discovered satiety gene.Given the fact that Nesfatin-1 and Ghrelin are both involved in the regulation of food intake,energy metabolism and insulin secretion,the hypothalamic-pituitary-gonad axis regulation,it is supposed that both are closely related to GHD.However,the current impact of recombinant human growth hormone(rhGH)on Nesfatin-1 and Ghrelin after the treatment of GHD has not been reported yet.This study is to observe the changes of serum levels of Nesfatin-1 and Ghrelin in GHD children before and after rhGH treatment and the correlation between the two,in order to provide a reliable basis for the effectiveness and safety of applying rhGH to treating GHD children in clinical practice.Method:Thirty CHD children diagnosed as pediatric patients in Hebei Provincial People’s Hospital from January 2017 to November 2017 were selected.According to the peak of GH,they were divided into complete absence of growth hormone(CGHD)and partial absence of growth hormone(PGHD).The morning fasting venous blood 4ml was drawn from the two groups children before the rhGH treatment and three months and six months after the treatment,for the detection of serum Ghrelin and Nesfatin-1.In this study,the serum levels of Ghrelin and Nesfatin-1 were detected by ELISA.Results:1.19 PGHD and 11 CGHD were included in 30 cases of GHD.There were no significant differences in gender,age,body weight,calcium,phosphorus and alkaline phosphatase among CGHD group and PGHD group(P> 0.05).2.After three months and six months treatment,the height and growth rate of PGHD group and CGHD group significantly increased(P<0.05)and the body BMI had no significant change(P>0.05)compared with those before the treatment.3.After three months and six months treatment,Serum Ghrelin significantly increased(P<0.05)but Nesfatin-1 was significantly decreased(P <0.05)in CGHD group compared with those before treatment.Serum Ghrelin and Nesfatin-1 both significantly decreased(P<0.05)in PGHD group compared with those before treatment.(P <0.05)4.Before treatment,Serum Ghrelin and Nesfatin-1 levels were positively correlated with height and growth rate.However,there was no correlation with calcium,phosphorus and alkaline phosphatase.Conclusion:1.It is confirmed that there is a close correlation among Ghrelin,Nesfatin-1 and GHD.2.RhGH have significant effect on children with GHD;it significantly accelerate the annual growth rate,but has no significant effect on BMI.3.Ghrelin plays an important role in children’s growth and development.Ghrelin levels in the PGHD group,before and after treatment,were significantly higher than those in the CGHD group,which suggests there may be ghrelin resistance.RhGH treatment can reduce ghrelin levels in PGHD and significantly increase the growth rate.4.The serum Nesfatin-1 levels in children with GHD continued to decrease after rhGH treatment,suggesting that Nesfatin-1 mainly regulates energy intake by inhibiting ingestion.It interacts with Ghrelin,a neuropeptide that promotes food intake,to affect children’s growth and development.