The blood level of acid-labile subunit in short children born small for gestational age with normosomatotropinemia




small for gestational age, children, acid-labile subunit, growth hormone, insulin-like growth factor-1, insulin-like growth factor-binding protein-3


Background. Insufficient growth in children born small for gestational age (SGA) is about 20 % of all cases of short stature. Despite the fact that most children born small for gestational age have a catch-up growth in early childhood (within 1–2 years of life), almost 10 % of these patients remain with persistent short stature for unknown reasons (Finken M.J.J. et al., 2018). The level of acid-labile subunit (ALS) plays a critical role in regulating the levels of insulin-like growth factor-1 (IGF-1) and the binding protein-3 (IGF-BP-3), which have an important role in regulating fetal and postnatal growth of the child. Today, it is not known exactly how these hormones affect the occurrence of SGA and postnatal growth of such patients. The purpose of the study was to determine the level of acid-labile subunit in the blood serum in SGA children with short stature with normal growth hormone. Materials and methods. We examined 25 prepubertal SGA children with short stature with the average age of 6.98 ± 0.55 years. All patients had two stimulation tests (insulin, clonidine). The growth factor was normal in all examined patients (> 10.0 ng/ml). The blood serum ALS was determined using a Cusabio ELISA kit (Houston, USA). The values are presented in SDS according to the age and gender. For statistical data processing, the Microsoft Excel software package was used. The results of the study are presented in the form of mean values and their standard error (M ± m). Pearson’s correlation coefficient was used to test for correlations. A P-value < 0.05 was considered significant. Results. The mean ALS level for all examined patients was –0.8 SDS, which is significantly lower than 0 SDS (p < 0.05). A decrease in the ALS level is accompanied by a significant decrease of IGF-1 and IGF-BP-3 levels. ALS SDS significantly correlates with IGF-1 SDS, r = 0.79 and IGF-BP-3 SDS, r = 0.67. We found a weak correlation in the total group of short SGA children between SDS ALS levels and patient growth, r = 0.25, and body weight, r = 0.18. In 9 SGA children with short stature (36 %), the levels of ALS, IGF-1 and IGF-BP-3 were in the range below –1.5 SDS (from –1.5 to –2.0 SDS). In this group of patients, ALS SDS significantly correlated with SDS growth (r = 0.66). SGA girls had lower ALS level than boys, –0.91 ± 0.18 SDS and –0.74 ± 0.17 SDS, respectively, although the difference between these indicators was not significant (p > 0.05). The study tested that the blood serum ALS increases with age (r = 0.74, p < 0.05). Conclusions. In the short SGA children with normosomatotropinemia, a decrease in serum acid-labile subunit levels is observed, and in 36 % of cases, its significant decrease was found (below –1.5 SDS). A decrease in the level of acid-labile subunit is accompanied by a significant decrease in the levels of insulin-like growth factor-1 and its binding protein. The total group of short SGA children showed a weak correlation between the SDS ALS levels and growth and body weight. However, it was found that the lowest levels of acid-labile subunit are associated with the greatest growth retardation in SGA children with short stature. It was found that the level of acid-labile subunit in blood serum increased with age both in groups of short SGA children and in children with growth hormone deficiency.


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How to Cite

Bolshova, O., & Muz, N. (2021). The blood level of acid-labile subunit in short children born small for gestational age with normosomatotropinemia. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 16(1), 32–38.



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