Objective:IGF1 concentration is the most widely used parameter for the monitoring and therapeutic adaptation of recombinant human growth hormone (rGH) treatment. However, more than half the variation of the therapeutic response is accounted for by variability in the serum concentrations of IGF1 and IGFBP3. We therefore compared the use of IGF1/IGFBP3 molar ratio with that of IGF1 concentration alone.Methods:We selected 92 children on rGH for this study and assigned them to three groups on the basis of growth deficiency etiology: small for gestational age (SGA), GH deficiency (GHD) and Prader-Willi syndrome (PWS). Plasma IGF1 and IGFBP3 concentrations and their molar ratio were determined.Results:Before rGH treatment, mean IGF1/IGFBP3 molar ratio in the SGA, GHD and PWS groups was 0.14±0.04, 0.07±0.01 and 0.12±0.02, respectively. After the initiation of rGH treatment, these averages were 0.19±0.07, 0.20±0.08 and 0.19±0.09, within the normal range for most children, even at puberty and despite some significant increases in serum IGF1 levels.Conclusion:We consider IGF1/IGFBP3 molar ratio to be a useful additional parameter for assessing therapeutic safety in patients on rGH, and for maintaning the values within the normal range for age and pubertal stage.

The mechanisms of diabetogenesis in children remain largely obscure. This study aimed to determine the impact of vitamin D and calcium supplementation on pancreatic β-cells function in terms of insulin secretion and sensitivity. This was a quasi-experimental study involving 30 obese and prepubescent Tunisian children (57% boys). During three months, the children received calcium and vitamin D supplementation at therapeutic doses. An oral glucose tolerance test (OGTT) was performed at the beginning and at the end of the study. The following metabolic definitions were applied: i) hyperinsulinism: insulinemia sum > 300 μ UI/ml during OGTT, ii) insulin-resistance: homeostatic model assessment of insulin-resistance > 2, iii) normal glycaemic profile: normal plasma levels during OGTT without any spike, and iv) pancreatic β-cells dysfunction reversibility: disappearance of the aforementioned disorders. The means ± standard-deviation of age and body mass index were 10.87 ± 1.9 years, and 30.17 ± 4.99 kg/m 2 , respectively. All children were at the stage of hyperinsulinism associated with insulin-resistance. These disturbances were noted even in children having a normal glycaemic profile at OGTT. After calcium and vitamin D supplementation, glycaemic profile as well as insulin-secretion improved significantly ( p < 0.0001 ). Hyperinsulinism and insulin-resistance decreased significantly by 56.67% ( p < 0.0001 ) and 70.00% ( p < 0.0001 ), respectively. Complete reversibility of these two disorders was noted in 26.6% of children. To conclude, in obese and prepubescent children, vitamin D and calcium supplementation led to the reversibility of the pancreatic β-cells dysfunction.

Objectives: in case of Polycystic Ovary Syndrome (SOPK), predicting ovarian response before undertaking risky in vitro fertilization (IVF) proceeds is crucial. Sex Hormone Binding Globulin (SHBG) is introduced in literature as an interesting indicator of follicle's maturation and quality. The aim of this study was to investigate whether serum SHBG levels are related to fertilization outcomes in SOPK women undergoing IVF procedures. Methods: in a prospective cohort study, we enrolled 61 SOPK women and 91 matched group of infertile women. All of them were undergoing FIV/ICSI proceeds. SHBG levels were performed in peripheral blood samples as well as others hormones determination. Results: we noted significant differences between our study group of SOPK patients and the Control group concerning the characteristics of the ovarian response to gonadotrophins administration and concerning the profile of biological proceeds' outcomes. But no significant correlation between SHBG and FIV/ICSI outcomes was found either in SOPK or in Control group. Conclusions: our study provides evidence that SHBG can't be considered as a predictor of IVF outcomes because production of this steroid-binding protein depends on many parameters such as metabolic disorders frequently associated with SOPK.

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