Abstract
Severe congenital heart disease (CHD) is frequently associated with early growth failure. We have investigated growth and nutritional status prospectively in 62 infants with CHD and in 40 healthy, age-matched controls. Measurements of serum IGF-I and IGFBP-1, which are both considered useful nutritional markers, have been measured by specific RIA after a 4 hour fast, at the time of cardiac catheterisation or surgery and have been related to growth and dietary intake data estimated from 3-day records. At a median age of 0.98 (range 0.02-2.70) years growth failure was evident.
Serum IGF-I was significantly lower in infants with CHD than in controls (mean IGF-1 for CHD = 30 ng/ml v 61 ng/ml in controls; P<0.001). Within the study group serum IGF-1 was weakly correlated with weight (r=0.34) and calorie intake (r=0.33) but no combination of variables studied explained more than 10% of the variance in serum IGF-1. A BMI SDS <−2.0 was associated with significantly lower IGF-1 levels (mean IGF-1 = 23 ng/ml v 38 ng/ml in those with BMI SDS >−2.0; P=0.03). IGF-1 levels were similar in patients with and without cyanosis. IGFBP-1 was inversely correlated with age (r=0.43) but was not correlated with any anthropometric parameter studied. Mean serum IGFBP-1 was 441 (95%CI 370-525) ng/ml in those <1 year (Normal 69 ng/ml; nonfasting*) and 292 (250-341) ng/ml in older subjects (Normal 55 ng/ml; non-fasting*). The low IGF-1 and elevated IGFBP-1 levels suggest that nutritional deficiency is an important factor in the poor growth seen in CHD.
(*Hall et al., Acta Endocrinol (1988), 118:321-326)
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Barton, J., Harris, A., Hindmarsh, P. et al. SERUM IGF-1 AND IGFBP-1 LEVELS IN INFANTS WITH CONGENITAL HEART DISEASE. Pediatr Res 33 (Suppl 5), S36 (1993). https://doi.org/10.1203/00006450-199305001-00198
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DOI: https://doi.org/10.1203/00006450-199305001-00198