Standard and low‐dose IGF‐I generation tests and spontaneous growth hormone secretion in children with idiopathic short stature

Blair, Joanne; Camacho-Hübner, C; Moud, F. Miraki; Rosberg, Sten; Burren, Christine P; Lim, Sheow Lei; Clayton, Peter E.; Bjarnason, Ragnar; Albertsson‐Wikland, Kerstin; Savage, Martin O.

doi:10.1046/j.1365-2265.2004.01957.x

Cited by 49 publications

(40 citation statements)

References 39 publications

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“…31 Our findings are in disagreement, however, with a recent study which reported that the peak IGF-I response occurs by 36 hours following a standard dose of hGH. 40 In ISS, variable results have been reported with regard to the IGF-I response during the IGF-I gen, possibly reflecting the heterogeneity in the etiology of ISS. There are older reports indicating that there is an enhanced response of IGF-I during the generation test in children with ISS.…”

Section: Discussionmentioning

confidence: 99%

The insulin-like growth factor-I (IGF-I) generation test as an indicator of growth hormone status

Spiliotis

Alexandrides

Karystianos

et al. 2009

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OBJECTIVE: The aim of the study was to evaluate the IGF-I generation test (IGF-I gen) as a possible indirect test of Growth Hormone (GH) secretory status. METHODS: Sixty-five GH deficient (GHD 1 and 2) and 86 control children were studied. Children in the GHD-1 subgroup (n=33) had low GH values (<10μg/L) after clonidine and levo-dopa while those in the GHD-2 subgroup (n=32) had normal GH values after pharmacologic provocation but low 24-hour GH secretory rates compared to 187 Normal Statured (NS) children. Of the 86 controls, who underwent IGF-I gen, 50 were NS and 36 Short-Statured (SS). Serum IGF-I was measured prior to and daily during hGH administration (hGH 0.033 mg/kg/day x 4 days). RESULTS: The prepubertal and pubertal GHD-1 and GHD-2 children had low baseline IGF-I values but their peak IGF-I values during the IGF-I gen reached those of the controls. The percent increase of IGF-I during the test was greater in the GHD groups than in the controls; in the prepubertal groups: 516±58% in the GHD-1, 433±50 % in the GHD-2, 106±12 % in the NS, and 102±18 % in the SS (p=0.001); in the pubertal groups: 191±28 % in the GHD-1, 141±20 % in the GHD-2, 48±8 % in the NS, and 61±17 % in the SS (p=0.003). CONCLUSIONS: The IGF-I response during the IGF-I gen seems to reflect the GH status in children.

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Section: Discussionmentioning

confidence: 99%

The insulin-like growth factor-I (IGF-I) generation test as an indicator of growth hormone status

Spiliotis

Alexandrides

Karystianos

et al. 2009

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“…The IGFGT has also been evaluated in the characterisation of patients with short stature (9,10,11). The rationale for the use of IGFGT in patients with short stature, in particular in those with apparent idiopathic short stature (ISS), is to determine whether reduced GH sensitivity is an explanation for the phenotype (10,12,13). Investigators have also used the IGFGT to assess whether GHI contributes to short stature associated with various medical conditions, such as b-thalassaemia (14,15,16,17), HIV infection in children (18), juvenile idiopathic arthritis (19), osteogenesis imperfecta (20), immunodeficiency (21) and Turner syndrome (22,23).…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, tests to assess responsiveness to GH, beyond baseline IGF1, IGFBP3 and GH levels and possibly GH-binding protein (GHBP) levels, are limited to the IGF1 generation test (IGFGT). The IGFGT measures circulating IGF1 levels generated in response to s.c. recombinant human GH (rhGH) administration (3,4,5,6,7,8,9,10,11,12,13). Additionally, in some situations, other GH-dependent peptides, such as IGFBP3 and/or ALS, can also be measured following rhGH administration.…”

Section: Introductionmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Limitations of the IGF1 generation test in children with short stature

Coutant

Dörr

Gleeson

et al. 2012

European Journal of Endocrinology

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The IGF1 generation test (IGFGT) is often used during the assessment of suspected GH insensitivity (GHI). We report the results of a survey undertaken in 2010 to determine the use of IGFGT amongst members of the European Society for Paediatric Endocrinology to evaluate suspected GHI. The literature surrounding the usefulness and limitations of IGFGT are reviewed, and recommendations provided for its use. Of 112 paediatric endocrinologists from 30 countries who responded to the survey, 91 (81%) reported that they had used the IGFGT in the previous 2 years; O10 IGFGT protocols were used. The IGFGT impacted treatment decisions for 97% of the respondents and was a prerequisite for recombinant human IGF1 treatment for 45% of respondents. From a literature review, sensitivity of the IGFGT was evaluated as 77-91% in molecularly proven cases of GHI; specificity was %97%, depending on the protocol. The positive predictive value of the IGFGT is likely to be low, as the frequency of normality is predictably higher than that of abnormality in GH signalling. Given the limitations of the IGFGT in the most severe cases of GHI syndrome (GHIS), the ability of the IGFGT to detect less severe GHIS is doubtful. In a pragmatic approach, the IGFGT may not be useful for the diagnosis of GHIS.

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“…Buckway et al [39] used 0.025 and 0.05 mg/kg/day dose and observed little advantage of larger rhGH dose. Blair et al [40] did test in idiopathic short stature (ISS) children using a standard dose (0.033 mg/kg/day) and low dose (0.011 mg/kg/day) observing a better result with the higher dose. From Stanhope et al [41] and Albertsson-Wikland et al [42] studies was selected the use of a dose of 0.05 mg/kg/day as they postulated that the presence of some resistance to GH action by children with SRS.…”

Section: Discussionmentioning

confidence: 99%

IGF-I and IGF Binding Protein-3 Generation Tests and Response to Growth Hormone in Children with Silver-Russell Syndrome

Beserra

Ribeiro

Collett‐Solberg

et al. 2010

International Journal of Pediatric Endocrinology

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Objectives. To evaluate, in children with Silver-Russell Syndrome, the response to the IGF-I and IGFBP-3 generation test and compare results to the growth response after 6 months of rhGH. Methods. Eight children (6 males), with a mean age of 5.71 ± 2.48 years and height SDS of −3.88 ± 1.28 received rhGH for 6 months. IGF-I and IGFBP-3 were analyzed before and after 4 doses of rhGH. Results. The mean growth velocity (GV) before treatment was 5.28 ± 1.9 cm/year. GV increased after rhGH in five children to a mean GV of 10.3 ± 3.64 cm/year. Six children had normal basal IGF-I levels and two low levels. After 4 doses of rhGH, the IGF-I levels were normal in seven. There was no correlation between the growth response and the IGF-I generation test. Conclusions. Children with SRS have normal IGF-I generation test. There is no correlation between the generation test and the growth velocity after 6 months of rhGH.

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Standard and low‐dose IGF‐I generation tests and spontaneous growth hormone secretion in children with idiopathic short stature

Cited by 49 publications

References 39 publications

The insulin-like growth factor-I (IGF-I) generation test as an indicator of growth hormone status

The insulin-like growth factor-I (IGF-I) generation test as an indicator of growth hormone status

DIAGNOSIS OF ENDOCRINE DISEASE: Limitations of the IGF1 generation test in children with short stature

IGF-I and IGF Binding Protein-3 Generation Tests and Response to Growth Hormone in Children with Silver-Russell Syndrome

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