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The IGF/IGFBP system in relation to macroscopic bone architecture in pediatric renal transplant patients.
- Source :
-
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2010 Apr; Vol. 25 (4), pp. 659-67. Date of Electronic Publication: 2009 Dec 22. - Publication Year :
- 2010
-
Abstract
- The post-transplant bone disease of the peripheral skeleton in pediatric renal transplant recipients is characterized by an inadequately thin bone cortex in relation to muscular force. A major hormonal modulator of periosteal growth is the insulin-like growth factor (IGF)/IGF binding protein (IGFBP) system. We therefore hypothesized that the reduced cortical thickness in these patients may be due to functional IGF deficiency. To test this hypothesis, we investigated 55 patients (mean estimated glomerular filtration rate 86.3 +/- 30.0 ml/min/1.73 m(2)) in a cross-sectional study. Parameters of macroscopic bone architecture and forearm muscle size were analyzed by peripheral quantitative computed tomography (pQCT), and serum IGF/IGFBP system components were measured by specific radioimmunoassays. The mean (+/- standard deviation) standardized serum IGF-I (0.20 +/- 1.16 score) level was normal, while the mean IGF-II (1.16 +/- 0.11 score) level was significantly elevated. Serum IGFBP-1 and IGFBP-2 levels were not altered, whereas the IGFBP-3 (1.34 +/- 0.15 score) level was significantly increased. The serum IGFBP-4 level was slightly elevated (by 11%), the IGFBP-6 level was markedly (2.3-fold) elevated, while the IGFBP-5 level was comparable to that of the control. The respective age-adjusted cortical thickness at both the proximal (r = 0.407, P < 0.005) and distal (r = 0.383, P < 0.01) forearm was positively correlated with the standardized serum IGF-I level. In conclusion, the serum IGF/IGFBP system in pediatric renal transplant recipients is characterized by an increase in the levels of the inhibitory IGFBPs, IGFBP-3, -4 and -6, resulting in a functional IGF deficiency. The positive correlation of IGF-I with cortical thickness underlines the importance of this hormonal system in the modeling of bone, particularly periosteal growth.
- Subjects :
- Adolescent
Child
Chronic Kidney Disease-Mineral and Bone Disorder etiology
Chronic Kidney Disease-Mineral and Bone Disorder pathology
Cross-Sectional Studies
Female
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic surgery
Male
Muscle, Skeletal diagnostic imaging
Muscle, Skeletal pathology
Prospective Studies
Radioimmunoassay
Tomography, X-Ray Computed
Young Adult
Bone and Bones diagnostic imaging
Chronic Kidney Disease-Mineral and Bone Disorder metabolism
Insulin-Like Growth Factor Binding Proteins blood
Kidney Transplantation
Somatomedins analysis
Somatomedins deficiency
Subjects
Details
- Language :
- English
- ISSN :
- 1432-198X
- Volume :
- 25
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 20033221
- Full Text :
- https://doi.org/10.1007/s00467-009-1405-5