Growth hormone/insulin-like growth factor-1 axis: A possible non-nutritional factor for growth retardation in children with cerebral palsy

Objective: to assess growth hormone (gh)/insulin like growth factor-1 (igf-1) axis as a possible non-nutritional factor for growth retardation in children with cerebral palsy (cp). methods: a case-control study was conducted at a tertiary university hospital. thirty children with cp (seven children with normal growth [cp-n] and 23 with retarded growth [cp-r]),30 children with protein energy malnutrition (pem),and 30 healthy children (ref group) underwent an assessment of growth parameters,serum igf-1,basal gh,and peak gh after stimulation with insulin. results: pem patients had higher basal gh levels than cp-n,cp-r and ref groups (p = 0.026,p < 0.001,and p < 0.001 respectively). after insulin stimulation,cp-n,cp-r,and pem patients had lower gh levels compared to the ref group (p = 0.04,p = 0.007,and p = 0.036 respectively). igf-1 levels were lower in cp-r group compared to cp-n and ref groups (p = 0.037 and p < 0.001 respectively),and in pem group compared to cp-n and ref groups (p < 0.001 and p < 0.001 respectively). conclusions: cp-r patients failed to demonstrate the same high basal gh response as pem patients,and responded inadequately to the insulin stimulation test,but they had igf-1 levels comparable to those of pem patients. on the other hand,cp-n patients behaved as controls regarding their basal gh and igf-1 levels,but failed to respond adequately to the insulin stimulation test. the pem group presented high basal gh and low igf-1 levels. these findings suggest that non-nutritional factors contribute to growth retardation in cp children. copyright © by sociedade brasileira de pediatria.