Abstract: Objective To compare serum level of resistin, leptin, and fibroblast growth factor 23(FGF-23)in children with growth hormone deficiency(GHD), children with idiopathic short stature(ISS), and healthy(children) control(HC) in order to evaluate the dynamic effects and clinical significance of one-year growth hormone(GH) therapy on these biomarkers. Methods This prospective cohort study enrolled 25 children with GHD, 25 children with ISS and 30 healthy children. Children with GHD received one-year growth hormone therapy. Fasting venous blood samples were collected before growth hormone therapy and at 6 and 12 months during treatment. Serum resistin, leptin, and FGF-23 levels were measured using ELISA. Clinical parameters including height, weight, growth velocity(GV),insulin-like growth factor 1(IGF-1), lipid profiles, fasting blood glucose(FBG), and homeostatic model assessment of insulin resistance(HOMA-IR) were collected at the same time. A linear mixed-effects model was used to adjust for confounders and evaluate indicator changes. Results The baseline level of serum resistin and FGF-23 in the GHD group was significantly higher than those in the healthy controls group(P＜0.05), leptin level was significantly higher than those in the ISS group(P＜0.05). After one-year GH therapy all three biomarkers significantly decreased in GHD children(P＜0.01) and was still significant after adjustment for age, gender, body mass index standard deviation score(BMI SDS), and IGF-1 standard deviation score(IGF-1 SDS). Concurrently, height standard deviation score(Ht SDS) improved from(-1.8±0.7) to(-1.5±2.2), annual growth velocity increased from(4.6±1.1)cm/year to(9.3±1.7)cm/year, and IGF-1 SDS significantly increased(P＜0.001). During treatment, FBG and triglyceride level mildly increased(P＜0.05,P＜0.01), but still kept within normal reference ranges; other metabolic parameters showed no significant changes. Conclusions GH therapy significantly improves linear growth and reduces resistin, leptin, and FGF-23 levels in children with GHD, demonstrating good short-term metabolic safety.

Key words: growth hormone deficiency, growth hormone therapy, resistin, leptin, fibroblast growth factor 23