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Why do normal children have acromegalic levels of IGF-I during puberty?

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CONTEXT: The rapid pubertal height growth is unique to humans, but why do we have it? Although the spurt contributes 13-15% to the final adult height, we hypothesize that the biological significance of the high acromegalic levels of GH and IGF-I which are behind the pubertal growth spurt may primarily be to stimulate reproductive organs.

EVIDENCE SYNTHESIS: Animal data demonstrate that adult Igf1 and Igf2 gene knockout mice that survive show a dramatic reduction in the sizes of reproductive organs, and are infertile. In humans, case reports of mutations in genes affecting the GH-IGF axis and growth (GH, GHRH, GH-R, STAT5b, IGF-I, IGF-II, IGF-1R, PAPPA2) are also characterized by delayed pubertal onset and micro-penis. Furthermore, GH treatment tend to normalize penile size in GHD patients. We believe that endocrine effects of high IGF-I levels may be needed for transition of the sexual organs, including secondary sex characteristics from the 'dormant' stages of childhood into full functioning reproductive systems.It is noteworthy that peak IGF-I levels on average occur two years after peak height growth velocity suggesting other reasons than longitudinal growth for the high IGF-I levels. and remain high in years after the height spurt, when the reproductive systems become fully functional.

CONCLUSION: We suggest that serum levels of IGF-I should be watched in children with poor development of sexual organs, although it remains to be investigated whether GH in some cases should be added to sex steroids in management of hypogonadism in pubertal children, e.g. in boys with micro-penis.

Original languageEnglish
Article numberjcem_201802099
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number7
Pages (from-to)2770-2776
Number of pages7
ISSN0021-972X
DOIs
Publication statusPublished - 21 Mar 2019

ID: 56782560