Development of a predictive model of growth hormone deficiency and idiopathic short stature in children

Abstract

The aim of the present study was to develop predictive models using clinical features and MRI texture features for distinguishing between growth hormone deficiency (GHD) and idiopathic short stature (ISS) in children with short stature. This retrospective study included 362 children with short stature from Children's Hospital of Hebei Province. GHD and ISS were identified via the GH stimulation test using arginine. Overall, there were 190 children with GHD and 172 with ISS. A total of 57 MRI texture features were extracted from the pituitary gland region of interest using C++ language and Matlab software. In addition, the laboratory examination data were collected. Receiver operating characteristic (ROC) regression curves were generated for the predictive performance of clinical features and MRI texture features. Logistic regression models based on clinical and texture features were established for discriminating children with GHD and ISS. Two clinical features [IGF-1 (insulin growth factor-1) and IGFBP-3 (IGF binding protein-3) levels] were used to build the clinical predictive model, whereas the three best MRI textures were used to establish the MRI texture predictive model. The ROC analysis of the two models revealed predictive performance for distinguishing GHD from ISS. The accuracy of predicting ISS from GHD was 64.5% in ROC analysis [area under the curve (AUC), 0.607; sensitivity, 57.6%; specificity, 72.1%] of the clinical model. The accuracy of predicting ISS from GHD was 80.4% in ROC analysis (AUC, 0.852; sensitivity, 93.6%; specificity, 65.8%) of the MRI texture predictive model. In conclusion, these findings indicated that a texture predictive model using MRI texture features was superior for distinguishing children with GHD from those with ISS compared with the model developed using clinical features.

A Clinical Study on the Treatment of Children’s Short Stature with Auxiliary Comprehensive Management Combined with Growth Patch

“…The theory of traditional Chinese medicine believes that the five internal organs of children have the physiological characteristics of “the heart and liver are surplus, but the lungs, spleen and kidney are often insufficient.” The growth of children's body and the development of wisdom depend on the nourishment of the kidneys, spleen, and stomach. According to modern research, the incidence of ISS is mostly related to heredity, and most of the children are accompanied by decreased expression of IGF-1 and IGFBP-3 and insufficient nutritional intake; as a result, growth is slowed down, the daily demand for nutrients is reduced, and the nutritional intake of children is reduced, and it forms a vicious circle with the slowdown of the body's growth, which will inevitably lead to short stature and underweight problems [ 16 , 17 ]. This is consistent with the view of traditional Chinese medicine theory that the kidney stores essence, which provides the necessary material basis for various functions of the human body, and the child's congenital deficiency of essence and blood affects the growth and development and leads to short stature; the spleen and stomach are the foundation of the acquired, digesting, absorbing, and spreading various nutrients needed for life activities; when the spleen and stomach have loss of transport, it will lead to anorexia, vomiting, diarrhea, stagnation or malnutrition in children, and other diseases, affecting nutrition intake, and then delayed development.…”