Failure of IGF-I and IGFBP-3 to diagnose growth hormone insufficiency
H Mitchell, MT Dattani, V Nanduri… - Archives of disease in …, 1999 - adc.bmj.com
H Mitchell, MT Dattani, V Nanduri, PC Hindmarsh, MA Preece, CGD Brook
Archives of disease in childhood, 1999•adc.bmj.comBACKGROUND 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 …
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 …
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.
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