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Journal of Tropical Pediatrics Advance Access published online on March 1, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp010
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Linear Growth in Relation to the Circulating Concentration of Insulin-like Growth Factor-I and Free Thyroxine in Infants and Children with Congenital Cyanotic Heart Disease Before vs. After Surgical Intervention

Amal El-Sisia, Aiman Khellaa, Mohamed Numana, Mohamed Dilwara, Akhlaque Bhata and Ashraf Solimanb

aDepartment of Pediatric Cardiology, Hamad General Hospital, P O Box 3050, Doha, Qatar
bDepartment of Endocrinology, Hamad General Hospital, P O Box 3050, Doha, Qatar

Correspondence: Ashraf T Soliman, Consultant Pediatric Endocrinologist, Department of Pediatrics, Hamad General Hospital, P O Box 3050, Doha, Qatar. Tel.: 009745983874. E-mail <atsoliman{at}yahoo.com>.


  Abstract

This prospective controlled study recorded the anthropometric data and measured the circulating insulin-like growth factor-I (IGF-I) in 16 children with congenital cyanotic heart disease before and a year after surgical intervention. At presentation patients were significantly shorter [length SD scores (LSDS) = –2.44 ± 1.31], vs. controls (LSDS = –0.25 ± 0.18). After surgical treatment the LSDS and growth velocity SD scores (GVSDS) increased significantly to (–) 0.25 ± 0.95 and 3.7 ± 2.1, respectively. IGF-I increased from 45.7 ± 26.3 ng ml–1 to 67.7 ± 16.4 ng ml–1. The GVSDS after treatment was correlated with the body mass index (BMI) (r = 0.339, p < 0.05) and negatively with the LSDS before surgery (r = –0.461, p < 0.05). The percentage increase of IGF-I after operation was correlated significantly with the BMI after surgical intervention (r = 0.82, p < 0.001). It appears that the postoperative growth spurt in infants with cyanotic congenital heart disease (CHD) is mediated through activation of the GH/IGF-I system and improved nutrition.


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