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.

Overview

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.