Characteristics of endothelin-1 levels depending on insulin-like growth factor 1 levels in children with COVID-19 and multisystem inflammatory syndrome
DOI:
https://doi.org/10.32782/2415-8127.2026.73.10Keywords:
insulin-like growth factor 1; endothelin-1; COVID-19; MIS-C; childrenAbstract
Dysregulation of the growth hormone (GH) – insulin-like growth factor 1 (IGF-1) axis in children infected with SARS-CoV-2, particularly decreased IGF-1 levels, may have not only endocrine consequences but also systemic effects, including impairment of vascular endothelial function. Endothelin-1 (ET-1) is considered one of the principal markers of endothelial dysfunction in both adults and children.
Objective: To investigate the characteristics of endothelin-1 levels in relation to IGF-1 levels in children infected with SARS-CoV-2.
A total of 78 children aged 1 month to 17 years were examined, including 63 with COVID-19 and 15 with multisystem inflammatory syndrome in children (MIS-C). Serum IGF-1 and ET-1 levels were measured using enzyme-linked immunosorbent assay. The associations between parameters were assessed using correlation analysis, IGF-1 quartile stratification, and multiple linear regression. A p value < 0.05 was considered statistically significant.
Significant differences in endothelin-1 levels were observed across IGF-1 quartiles: children in the lowest IGF-1 quartile (Q1) had significantly higher ET-1 levels (17.81 [11.00; 30.09] pg/mL) compared with those in the third (9.66 [8.32; 12.73] pg/mL) and fourth quartiles (9.75 [8.16; 12.36] pg/mL) (H=12.47; p=0.006). A significant negative correlation between IGF-1 and ET-1 levels was found (rs=–0.38, p<0.001). In multiple linear regression analysis, IGF-1 remained an independent predictor of higher ET-1 levels after adjustment for age and sex (β= –0.38; p=0.001).
Decreased IGF-1 levels in children with COVID-19 and MIS-C are associated with increased endothelin-1 levels, indicating the involvement of the GH–IGF-1 axis in the mechanisms underlying endothelial dysfunction in SARS-CoV-2 infection and supporting the rationale for comprehensive assessment of hormonal and vascular biomarkers in pediatric patients with severe COVID-19 and MIS-C.
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