Measurement of serum SMAD3 and miR-189 levels before and after rhGH treatment in children with idiopathic short stature and their value in prognosis evaluation
Objective To explore the changes in serum levels of Smad homolog 3(SMAD3)and microRNA(miR)-189 before and after recombinant human growth hormone(rhGH)treatment in children with idiopathic short stature(ISS),and analyze their prognostic value,providing a reference for clinical treatment.Methods A total of 136 children with ISS from February 2021 to May 2022 were selected as the observation group,all receiving rhGH treatment,and 136 healthy children were selected as the control group during the same period.Serum SMAD3 and miR-189 levels were compared be-tween the two groups.The serum levels of SMAD3,miR-189,bone age indexes[bone age index(BAI),bone age difference(BAD)]and physical indexes[height,weight,body mass index(BMI)]of ISS children were compared before and after rhGH treatment.According to the prognosis after 12 months of treatment,they were divided into good prognosis group and poor prognosis group.Serum SMAD3 and miR-189 levels of ISS children with different prognosis were compared to analyze the evaluation value of ISS children with different prognosis.Results The level of miR-189 in the observation group was higher than that in the control group,while the level of SMAD3 was lower than that in the control group(P＜0.05).After 3 and 6 months of rhGH treatment,compared with before treatment,the serum SMAD3 level,BAI,BAD,height,weight,and BMI in children with ISS were increased,while the serum miR-189 level was decreased(P＜0.05).In children with ISS,BAI,BAD,height,weight,and BMI were positively correlated with serum SMAD3,while negatively correlated with miR-189(P＜0.05).In the poor prognosis of children with ISS,the low expression of SMAD3 and the high expression of miR-189 interact positively,forming a secondary multiplicative model.The serum SMAD3 level in the good prognosis group was higher than that in the poor prognosis group before treatment and at 3 and 6 months after treatment,while the miR-189 level was lower than that in the poor prognosis group(P＜0.05).The AUC of SMAD3 and miR-189 combined assessment before treatment,at 3 and 6 months after treatment were 0.879,0.907,and 0.938,respectively(P＜0.05),indicating high assessment efficiency.Conclusion The abnormal changes in serum SMAD3 and miR-189 levels in children with ISS are related to bone age and physical fitness.The high expres-sion of miR-189 and low expression of SMAD3 have a positive interaction in poor prognosis.Early detection of serum SMAD3 and miR-189 can be used as an effective indicator for evaluating the prognosis of rhGH treatment,providing a refer-ence for subsequent treatment.
idiopathic short statureSMAD3microRNA-189recombinant human growth hormone
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