Investigating whether serum IGF-1 and IGFBP-3 levels reflect the height outcome in prepubertal children upon rhGH therapy: LG growth study database

Abstract

Serum insulin-like growth factor-1 (IGF-I) and IGF binding protein-3 (IGFBP-3) levels can be used to monitor the safety of recombinant human growth hormone (rhGH) therapy. In this study, we evaluated the changes in serum IGF-I and IGFBP-3 levels during rhGH therapy as a marker of height outcome in prepubertal children. Totally, 705 prepubertal children with short stature were enrolled from the LG Growth Study Database. Data for three groups of subjects were obtained as follows: Idiopathic GH deficiency (IGHD; n = 486); idiopathic short stature (n = 66); small for gestational age (n = 153). Serum IGF-I and IGFBP-3 levels at the baseline and after the 1st and 2nd year of rhGH therapy, as well as the Δheight standard deviation score (SDS), were obtained. Δheight SDS after the 1st and 2nd year of rhGH therapy had notably increased compared to that at the baseline for all three groups. IGF-I and IGFBP-3 levels in all three groups were significantly increased compared to those at the baseline (p <0.001). Δheight SDS was positively correlated with ΔIGF-1 SDS after the 1st year of therapy, ΔIGFBP-3 SDS after the 2nd year of therapy in the IGHD group, and ΔIGF-I SDS and ΔIGFBP-3 SDS after the 2nd year of therapy (p < 0.05), regardless of whether the height at the baseline was a covariate. The increase in IGF-I and IGFBP-3 levels during rhGH therapy was related to the growth response in children with IGHD. Therefore, it may be valuable to measure the change in serum IGF-I and IGFBP-3 levels, especially the latter, during rhGH treatment to predict the growth response upon long-term treatment.

An evaluation of IGF-1 and IGFBP-3 levels in patients receiving growth hormone therapy and these parameters therapeutic efficacy

“…These factors cast doubt on the use of IGFBP-3 as a diagnostic tool in evaluating the efficacy of GH therapy. Despite these disadvantages, some researchers have reported that changes in IGFBP-3 in children receiving GH therapy are significantly associated with growth response and have even suggested that IGFBP-3 may be a more useful marker than delta IGF-1 in predicting growth response (27). In the present study, we found that the increase in growth velocity in the first year in cases of GHD started on GH therapy was associated with increased IGFBP-3 levels.…”

“…On the other hand, Cutfield et al (26) determined that patients with GHD with low IGF-1 levels before GH therapy exhibited better growth responses in the first year of treatment. Kim et al (27) showed that serum Δ IGF-I levels measured in the first year of treatment in prepubertal cases with GHD started on GH therapy and for whom GH treatment was initiated can be used as a marker to predict the growth response. However, there are also opposing views.…”

Growth hormone therapy response in children with short stature

“…Growth response in the first year of rhGH therapy is one of the best indicators of long-term height gain [ 24 ]. By applying Bang criterion to our study, the majority of cases (75%) were poor responders [14 cases (66.7%) IGHD, 6 cases (75%) ISS, and 10 cases (91%) SGA] .…”

Effect of Body Mass Index and Blood Lipid on peak Growth Hormone Response in Children with Short Stature

“…Short stature is one of a growth and development disorder in children. Children with this disease have a signi cantly short stature for their age and gender and a deteriorated growth velocity, which seriously affect the physical and mental health of children and increase the family burden in varying degrees (10)(11)(12). Several factors, such as growth hormone de ciency, gene mutation, growth hormone resistance, and decreased growth hormone activity contribute to the development of short stature (13)(14)(15).…”