Chronic hypoxemia leads to reduced serum IGF-I levels in cyanotic congenital heart disease

Cyanotic congenital heart disease in children commonly causes more pronounc ed growth retardation in comparison with acyanotic congenital heart disease . Chronic hypoxemia has been suggested as the cause of poor growth in these patients, but the relationship between serum IGF-I levels and chronic hypo xemia is unclear. Serum IGF-I concentrations, oxygen saturation and nutriti onal status were evaluated in 29 patients with cyanotic congenital heart di sease, and serum IGF-I levels were compared with a group of 20 well-nourish ed, age-matched control children to assess the relationship between IGP-I l evels and chronic hypoxemia, The nutritional status of each patient was det ermined by using anthropometric parameters and calorie and protein intake r atios. The patients were divided into malnourished and well-nourished group s (21 and 8 patients, respectively) according to their nutritional status. Serum IGP-I concentrations were measured in the two patient groups and the controls. The malnourished group had the lowest IGF-I levels (48.14 +/- 21. 8 ng/ml, p < 0.05), However, the well-nourished group's IGP-I levels were s ignificantly lower than the control subjects' despite improved nutritional status (85.5 +/- 30.2 and 107 +/- 19.7 ng/ml, respectively, p < 0.05), In a ddition, me found a positive correlation between serum IGF-I levels and oxy gen saturation of the patients (r = 0.402, p < 0.05), These findings indica te that chronic hypoxemia has a direct or indirect effect to reduce serum I GF-I concentrations and this may be a cause of the increased growth failure in patients with cyanotic congenital heart disease.