Failure of IGF-I and IGFBP-3 to diagnose growth hormone insufficiency.

Abstract:

BACKGROUND:Growth hormone insufficiency (GHI) is diagnosed conventionally by short stature and slow growth, and is confirmed by diminished peak GH response to a provocation test. Insulin-like growth factor I (IGF-I) and IGF binding protein 3 (IGFBP-3) have previously been considered individually OBJECTIVE:To test the hypothesis that the combined analysis of IGF-I and IGFBP-3 could act as a surrogate marker for the diagnosis of GHI. DESIGN:Reference ranges for IGF-I and IGFBP-3 were calculated using 521 normal individuals. A retrospective analysis was performed on 318 children referred for investigation of short stature. RESULTS:No significant difference was found between either the IGF-I or IGFBP-3 standard deviation scores (SDSs) in children with and without GHI. If the requirement were for both tests to be positive (< -2 SDS) for a diagnosis of GHI, then 99% of children without GHI would be correctly identified; however, the sensitivity of the test was only 15%. CONCLUSIONS:Neither IGF-I nor IGFBP-3 alone is a marker for GHI. In addition, they cannot be used as an effective screening test in combination.

journal_name

Arch Dis Child

authors

Mitchell H,Dattani MT,Nanduri V,Hindmarsh PC,Preece MA,Brook CG

doi

10.1136/adc.80.5.443

subject

Has Abstract

pub_date

1999-05-01 00:00:00

pages

443-7

issue

5

eissn

0003-9888

issn

1468-2044

journal_volume

80

pub_type

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