Interactions of Thyroid Hormones; Insulin-like Growth Factor-1 (IGF-1), IGF Binding Proteins, and Nutritional Anthropometric Parameters in School Children with Goiter Detected by Palpation

Abstract

Aim: In the present study we evaluated anthropometric indices, serum thyroid hormones, insulin-like growth factor-1 (IGF-1) and IGF- binding proteins (IGFBPs) levels, in children who has palpable goiter at endemic population. We aimed to 1) compare children with palpable goiter with healthy peers, 2) detect interaction of anthropometric indices, serum thyroid hormones, IGF-1 and IGFBPs parameters in both groups 3) evaluate the effects of their nutritional status to these parameters.

Subjects and Methods: We performed goiter palpation to 1 018 child and found goiter at 81 child. Seventy-three pubertal children were included in this study. Seventy-five healthy children were defined as the control group. Weight and height of all children were measured. Thyroid hormone levels, IGF-1, IGFBP-3, and IGFBP-1 were assessed in both groups.

Results: Height and weight SDS were significantly lower in children who had goiter by palpation than healthy peers (p<0.05). Free T4 (FT4) levels were significantly higher in control group than children with palpable goiter (p<0.05). IGF-1 level and IGF-1 SDS were significantly lower in children with palpable goiter (p<0.001), IGFBP3 and IGFBP1 levels were not significantly different between the two groups (p>0.05). Serum IGF-1 and IGFBP-3 levels were significantly lower (p<0.05) in underweight children with goiter than normal weight group. In the presence of goiter, IGF-1 levels were lower (B: 0.97, 95% CI: 0.96–0.98, p<0.001).

Conclusion: In endemic areas, children with palpable goiter were shorter and thinner than the healthy peers. Thyroid hormones were between the reference ranges. In children with palpable goiter, IGF-1 levels were lower and IGFBP-3 and IGFBP-1 levels were not different from the healthy control group. However, at the presence of goiter IGF-1 levels decrease. This decrease can be the result of insufficient nutrition and result in short stature and weakness than their healthy peers.

Key words

goiter - IGF-1 - IGFBP-3 - IGFBP-1

References

• 1 Bloom WB, Albertsson-Wikland K, Rosberg S. et al . Serum levels of insulin-like growth factor I (IGF-I) and IGF Binding protein 3 reflect spontaneous growth hormone secretion.  J Clin Endocrinol Metabol. 1993;  76 1610-1616
• 2 Bona G, Rapa A, Boccardo G. et al . IGF-1 and IGFBP in congenital and acquired hypothyroidism after long-term replacement treatment.  Min Endocrinol. 1999;  24 51-55
• 3 Brabant G, Bergmann P, Kirsch CM. et al . Early adaptation of thyrotropin and thyroglobulin secretion to experimentally decreased iodine supply in man.  Metabolism. 1992;  37 504-510
• 4 Brahmbhatt SR, Brahmbhatt RM, Boyages SC. Impact of protein energy malnutrition on thyroid size in an iodine deficient population of Gujarat (India): is it an aetiological factor for goiter?.  Eur J Endocrinol. 2001;  145 11-17
• 5 Centanni MG, Miani G, Vermiglio F. et al . Combined impairment of nutritional parameters and thyroid homeostasis in mildly iodine-deficient children.  Thyroid. 1998;  8 155-159
• 6 Clayton PE, Hall CM. Insulin-like Growth Factor I levels in healthy children.  Horm Res. 2004;  62 ((suppl 1)) 2-7
• 7 Darcan S, Unak P, Yalman O. et al . Determination of iodine concentration in urine by isotope dilution analysis and thyroid volume of school children in the west coast of Turkey after mandatory salt iodization.  Clin Endocrinol (Oxf). 2005;  63 543-548
• 8 Delange F. The disorders induced by iodine deficiency.  Thyroid. 1994;  4 ((1)) 107-128
• 9 de Onis M, Blüssner M. World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications.  Inter J Epidemiol. 2003;  32 518-526
• 10 Dibley MJ, Staehling NW, Nieburg P. et al . Interpretation of Z-score anthropometric indicators derived from international growth reference.  Am J Clin Nutr. 1987;  465 749-762
• 11 Gelander L, Blum WF, Larsson L. et al . Monthly measurements of insulin-like growth factor I (IGF-I) and IGF-Binding Protein-3 in healthy prepubertal children: Characterization and relationship with growth: The 1-year growth study.  Pediatr Res. 1999;  45 377-383
• 12 Hetzel BS. Progress in the prevention and control of iodine deficiency disorders.  Lancet. 1987;  2 266
• 13 Inukai T, Takanashi K, Takebayashi K. et al . Thyroid hormone modulates insulin-like growth factor-I(IGF-I) and IGF-binding protein-3, without mediation by growth hormone, in patients with autoimmune thyroid diseases.  Hor Metabol Res. 1999;  31 576-579
• 14 Jooste PL, Faber M, Badenhorst CJ. et al . Nutritional status of primary school children with endemic goiter in Caprivi, Nambia.  Cent Afr J Med. 1994;  40 60-66
• 15 Kamoda T, Saitoh H, Hirano T. et al . Serum levels of free insulin-like growth factor (IGF)-Iand IGF-binding protein-1 in prepubertal children with idiopathic short stature.  Clin Endocrinol. 2000;  53 683-688
• 16 Knudsen N, Bülow I, Laurberg P. et al . Low socio-economic status and familial occurence of goitre are associated with high prevalence of goiter.  Eur J Epidemiol. 2003;  18 175-181
• 17 Levitt Katz LE, Satin-Smith MS, Collet-Solberg P. et al . Insulin-like growth factor binding protein-1 levels in the diagnosis of hypoglycemia caused by hyperinsulinism.  J Pediatr. 1997;  131 193-199
• 18 Lifshitz F, Botero D. Worrisome Growth, In Pediatric Endocrinology. Eds Lifshitz F(eds). New York, Marcel Dekker 2003: 1-47
• 19 Müller MJ, Burger AG, Ferrannini E. et al . Glucoregulatory function of thyroid hormones: role of pancreatic hormones.  Am J Physiol. 1989;  256 E101-E110
• 20 Nantö-Salonen K, Muller HL, Hoffman AR. et al . Mechanisms of thyroid hormone action on the insulin-like growth factor system: All thyroid hormone effects are not growth hormone mediated.  Endocrinol. 1993;  132 781-788
• 21 Ozkan B, Olgun HN, Ceviz. et al . Assessment of goiter prevalence, iodine status and thyroid functions in school-age children of rural Yusufeli district in eastern Turkey.  Turk J Pediatr. 2004;  46 16-21
• 22 Palacio AC, Perez-Bravo F, Santos JL. et al . Leptin levels and Igf-Binding proteins in malnourished children: effect of weight gain.  Nutrition. 2002;  18 17-19
• 23 Sagesse G, Cesaretti G, Franchi G. et al . Testosterone-induced increase of insulin-like growth factor I levels depends upon normal levels of growth hormone.  Eur J Endocrinol. 1996;  135 211-215
• 24 Savaya AL, Martins PA, Grillo LP. et al . Long-term effects of early malnutrition on body weight regulation.  Nutr Rev. 2004;  62 S127-S33
• 25 Stone T. Endemic goiter, nutrition and landholding in Bengladesh.  Inter J Epidemiol. 1984;  13 58-64
• 26 van den Briel T, West CE, Hautvast J. et al . Serum thyroglobulin and urinary iodine concentration are the most appropriate indicators of iodine status and thyroid function under conditions of increasing iodine supply in school children in Benin.  J Nutr. 2001;  131 2701-2706
• 27 Wan Nazaimon WM, Osman A, Wu LL. et al . Effects of iodine deficiency on insulin-like growth factor-I, insulin-like growth factor-binding protein-3 levels and height attainment in malnourished children.  Clin Endocrinol (Oxf). 1996;  45 79-83
• 28 WHO, UNICEF, ICCIDD . Indicators for assesing iodine deficiency disorders and their control through salt iodization, WHO/NUT, 94.6. Geneva: WHO 1994
• 29 World Health Organization . Data analysis and interpretation. In measuring Change in Nutritional Status, first edn, ch 6. Ed WHO Geneva: WHO 1983: 19-28
• 30 Zimmerman-Belsing T, Juul A, Juul-Holst J. et al . The insulin-like growth axis in patients with autoimmune thyrotoxicosis: effect of antithyroid drug treatment.  Growth Horm IGF Res. 2004;  14 235-244
• 31 Zimmermann M, Saad A, Hess S. et al . Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency.  Eur J Endocrinol. 2000;  143 727-731

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