Clinical utility of insulin-like growth factor binding protein-3 in the evaluation and treatment of short children with suspected growth hormone deficiency

Abstract

We have shown previously that serum insulin-like growth factor binding protein-3 (IGFBP-3) levels have good predictive value for complete, but not partial, growth hormone deficiency (GHD). In this study, we compare IGFBP-3 levels in short children previously divided into groups on the basis of their post-stimulation GH levels. Complete GHD (N = 59) included those children with peak post-stimulation GH < 5 micrograms/l. The partial GHD group (N = 49) had post-stimulation GH peaks of > 5 micrograms/l but < 10 micrograms/l. The normal children with short stature (N = 103) had post-stimulation GH peaks > 10 micrograms/l. Partial GHD and normal children with short stature also were divided into either low IGF-I or normal IGF-I subgroups. The clinical sensitivity of IGFBP-3 for complete GHD was 92%, whereas its sensitivity for partial GHD was 39%. For partial GHD, among those with low IGF-I (N = 19) 68% were also low for IGFBP-3, while 80% of those with normal IGF-I (N = 30) were also normal for IGFBP-3. The clinical specificity of IGFBP-3 for normal children with short stature was 69%. For these groups, among those with low IGF-I (N = 22) 73% also were low for IGFBP-3, while 80% of those with normal IGF-I (N = 81) also were normal for IGFBP-3. In addition, we tested whether IGFBP-3 can predict the response to GH treatment in prepubertal children by comparing pretreatment IGFBP-3 with the height gain achieved by 1 year of GH treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Development of Growth Hormone and Adrenocorticotropic Hormone Deficiencies in Patients with Prenatal or Perinatal-Onset Hypothalamic Hypopituitarism Having Invisible or Thin Pituitary Stalk on Magnetic Resonance Imaging.

“…ACTH secretion capacity was also evaluated following suspension of cortisol for one to two days. GH levels were measured using radioimmunoassay (RIA, Eiken, Tokyo) and immunoradiometric assay [7] (IRMA, Eiken, Tokyo) in five hospitals. GH levels measured by RIA were converted into IRMA values [7].…”

IMMULITE® 2000 age and sex-specific reference intervals for alpha fetoprotein, homocysteine, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, C-peptide, immunoglobulin E and intact parathyroid hormone

“…Low IGFBP3 concentrations indicate GH deficiency, while high concentrations reflect GH excess. IGFBP-3 concentrations have been shown to have good predictive value for complete, but not partial, growth hormone deficiency (GHD) [14].…”

Clinical Utility of Insulin-Like Growth Factor-I (IGF-I) and IGF Binding Protein-3 Levels in the Diagnosis of GH Deficiency (GHD) During Childhood.

“…The percentage of patients with CGHD and PGHD who had low IGF-I levels (less than the 5th percentile for each age) was 88% and 39%, respectively [5]. Similarly, the percentage of patients with CGHD and PGHD who had low IGFBP-3 levels (less than the 5th percentile for each age) was 92% and 39%, respectively [5].…”

“…Among children who had at least one GH peak of more than 10 ng/ml, the percentage of discordance between GH peaks in GH provocation tests in terms of below and above 10 ng/ml (the percentage where one GH peak in these two provocation tests was less than 10 ng/ml and one of the other GH peaks was more than 10 ng/ml) was 19, 25 % for the arginine test, and insulin test, respectively [4]. IGF-I and IG-FBP-3 levels were measured as previously described [5]. The 5th percentile for each age was used as the cutoff value for low IGF-I and IGFBP-3 for each age.…”