Reevaluation of Growth Hormone Deficiency During and After Growth Hormone (GH) Treatment: Diagnostic Value of GH Tests and IGF-I and IGFBP-3 Measurements

2004 ◽  
Vol 17 (7) ◽  
Author(s):  
F. Darendeliler ◽  
I. Spinu ◽  
F. Bas ◽  
R. Bundak ◽  
P. Isgüven ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Diagnostic Value ◽  
Hormone Deficiency ◽  
Gh Treatment ◽  
Igf I ◽  
Igfbp 3

scholarly journals The usefulness of serum IGF-1 and serum IGFBP-3 for the diagnosis of growth hormone deficiency in comparison to clonidine stimulation test: a prospective cohort study

2021 ◽  
Vol 8 (2) ◽  
pp. 327
Author(s):  
Hemlin Thomas C. ◽  
Sanjeev Kumar ◽  
Bisto A. A.
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Age Groups ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Older Age ◽  
Stimulation Test ◽  
Hormone Deficiency ◽  
Age Group ◽  
Igfbp 3

Background: Growth Hormone Deficiency is conventionally diagnosed by low peak Growth Hormone levels to provocative testing. Serum IGF-1 and IGFBP-3 are under the influence of GH and reflect the endogenous GH secretion. Owing to the absence of a circadian rhythm, it is possible to take individual measurements of IGF-1 and IGFBP-3 at any time of the day for evaluation of GH status instead of subjecting the individual to cumbersome provocative tests. Objectives of this study were to compare IGF-1 and IGFBP-3 assays with clonidine stimulation test in children of different age group with short stature.Methods: 90 children with short stature were included in the study. Samples for basal GH, IGF-1 and IGFBP-3 were obtained and afterwards all children were subjected to clonidine stimulation test. The diagnostic value of the tests were analysed in terms of sensitivity, specificity, predictive value and accuracy in younger and older age groups.Results: 40% of the study population was diagnosed to have GHD. IGF-1 had high sensitivity in both age groups. But in the younger age group IGFBP-3 was more specific. Both the tests had same specificity in the older age group. Combining the two tests helped to improve diagnostic value in all the age groups.Conclusions: Measurements of IGF-1 and IGFBP-3 have shown comparable diagnostic performance with growth hormone stimulation tests and are valuable for patient`s convenience and ease of performance and can be useful in the workup of growth hormone deficiency.

Diagnostic Value of Serum Acid-Labile Subunit Alone and in combination with IGF-I and IGFBP-3 in the Diagnosis of Growth Hormone Deficiency

2020 ◽  
pp. 1-9
Author(s):  
Diana-Alexandra Ertl ◽  
Jiajia Chen ◽  
Andreas Gleiss ◽  
Dominik Janu ◽  
Susanne Sagmeister ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Hormone Deficiency ◽  
Igf I ◽  
Acid Labile Subunit ◽  
Diagnostic Work ◽  
Work Up ◽  
Acid Labile ◽  
Diagnostic Work Up ◽  
Igfbp 3

<b><i>Background:</i></b> The acid-labile subunit (ALS) is a crucial factor in the tertiary complex. IGF-I and IGFBP-3 are routinely measured during the diagnostic work-up for growth hormone deficiency (GHD). The aim of the study is to evaluate the relevance of serum ALS as an additional biomarker in the diagnosis of GHD. <b><i>Methods:</i></b> Ninety-one children undergoing standard diagnostic work-up for GHD were included in this retrospective study. Inclusion criteria were evidence-based auxological cutoffs, IGF-I and IGFBP-3 &#x3c;−2 SDS at first presentation, at least 1 growth hormone (GH) stimulation test, and IGF-I, IGFBP-3, and ALS measurements on the same day. Statistical analysis was performed by ROC as well as by odds ratio calculations. <b><i>Results:</i></b> Forty-seven of 90 participants presented with peak GH values under the cutoff of 7 ng/mL. AUC from a model containing only IGF-I was 0.76 and 0.68 when using only ALS. A model containing IGF-I, IGFBP-3, and ALS (AUC = 0.77) did not improve the result compared to the combination of IGF-I/IGFBP-3 (0.77) or IGF-I/ALS (0.76). Furthermore, the variation in the outcome (GH peak &#x3c;/≥7) explained by IGF-I only amounts to 20.4%, while that explained by IGFBP-3 and ALS is only 10.6 and 7.8%, respectively. The sensitivity to diagnose GHD at respective concentrations of −2.0 SDS was 48% for IGF-I, 38% for IGFBP-3, and only 8% for ALS. <b><i>Conclusion:</i></b> Determination of serum ALS alone or in combination with IGF-I and IGFBP-3 did not improve definition of biochemical GHD in a cohort of short children and adolescents with suspected growth disorder. However, performance of IGFBP-3 in this context was not statistically superior to ALS.

scholarly journals Familial growth hormone deficiency with mutated GHRH receptor gene: clinical and hormonal findings in homozygous and heterozygous individuals from Itabaianinha

2000 ◽  
pp. 557-563 ◽  
Author(s):  
CY Hayashida ◽  
RG Gondo ◽  
C Ferrari ◽  
SP Toledo ◽  
R Salvatori ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Autosomal Recessive ◽  
Novel Mutation ◽  
Statistical Significance ◽  
Standard Deviation Score ◽  
Hormone Deficiency ◽  
R Gene ◽  
Igf I ◽  
Igfbp 3

OBJECTIVE: To characterize clinically and hormonally the syndrome of autosomal recessive familial growth hormone deficiency (FGHD) recently identified in Itabaianinha, Sergipe, Brazil, caused by a novel mutation (mt) that inactivates the growth hormone-releasing hormone receptor (GHRH-R) gene. DESIGN: Clinical and hormonal evaluations were performed in 21 FGHD individuals (mt/mt group) aged 8 to 63 years, 13 heterozygotes for the GHRH-R mutation (wt/mt group) and 5 homozygotes for the wild type (wt) allele (wt/wt group), identified by genotyping of peripheral blood leukocyte DNA. METHODS: Clinical and hormonal characterization included physical examination and measurement of GH, IGF-I, IGF binding protein-3 (IGFBP-3), cortisol, prolactin, LH, FSH, and free thyroxine (FT4). RESULTS: Clinical features were consistent with isolated growth hormone deficiency. Height was significantly reduced in the mt/mt group compared with the wt/mt group (mean height standard deviation score (SDS) +/- s.d.: -7.35+/-1.37 vs -1.84+/-1.44 respectively, P<0. 0001), and the wt/wt group (-1.85 +/- 0.81, P=0.0007). The height of the 13 wt/mt subjects did not differ from the 5wt/wt individuals. Serum GH, IGF-I, IGF-I SDS, IGFBP-3 and IGFBP-3 SDS were all significantly lower in the mt/mt group than in the wt/mt and wt/wt groups. Two affected children treated with GH for 1 year showed a normal growth response. Serum IGF-I and IGF-I SDS were lower in wt/mt compared with wt/wt group, but did not reach statistical significance. IGF-I and IGF-I SDS correlated inversely with age in wt/mt group. CONCLUSIONS: FGHD due to an autosomal recessive GHRH-R gene mutation leads to marked dwarfism, phenotypically and hormonally indistinguishable from other forms of isolated GH deficiency. Heterozygotes for the GHRH-R mutation appear to have a partial defect in the GH/IGF axis, with no apparent height impairment.

scholarly journals Relationship between IGF-I Concentration and Metabolic Profile in Children with Growth Hormone Deficiency: The Influence of Children’s Nutritional State as well as the Ghrelin, Leptin, Adiponectin, and Resistin Serum Concentrations

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Renata Stawerska ◽  
Joanna Smyczyńska ◽  
Maciej Hilczer ◽  
Andrzej Lewiński
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Body Mass ◽  
Metabolic Profile ◽  
Hormone Deficiency ◽  
Molar Ratio ◽  
Healthy Children ◽  
Serum Concentrations ◽  
Igf I ◽  
Igfbp 3

Background. Some, however not all, children with growth hormone deficiency (GHD) reveal a tendency towards metabolic disorders. Insulin-like growth factor I (IGF-I) is the main mediator of GH anabolic effects. Objective. The aim of the study was to compare ghrelin, adiponectin, leptin, resistin, lipid, glucose, and insulin concentrations in GHD children, depending on the IGF-I bioavailability. Methods. The analysis comprised 26 children with GHD, aged 5.7–15.3 yrs. Fasting serum concentrations of IGF-I, IGFBP-3, ghrelin, leptin, adiponectin, resistin, lipids, glucose, and insulin were measured. The GHD children were divided into two subgroups: (1) with lower IGF-I/IGFBP-3 molar ratio and (2) with higher IGF-I/IGFBP-3 molar ratio. The control group consisted of 39 healthy children, aged 5.1–16.6 yrs, of normal height and body mass. Results. GHD children with lower IGF-I/IGFBP-3 molar ratio were found to have a significantly lower body mass and insulin and triglyceride concentrations, as well as significantly higher ghrelin and adiponectin concentrations than GHD children with higher IGF-I/IGFBP-3. Conclusions. A better metabolic profile characterised GHD children with low IGF-I bioavailability. This phenomenon may be the result of high adiponectin and ghrelin concentrations in those children and their influence on adipose tissue, glucose uptake, and orexigenic axis.

scholarly journals IGF-1 and IGFBP 3 in Growth Hormone Deficiency Role of Insulin Like Growth Factor-1 (IGF-1) and IGF Binding Protein 3 in the Diagnosis of Growth Hormone Deficiency: Changing Paradigm

2012 ◽  
Vol 32 (2) ◽  
pp. 154-162 ◽  
Author(s):  
SK Kota ◽  
S Jammula ◽  
K Gayatri ◽  
SK Kota ◽  
PR Tripathy ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Gh Deficiency ◽  
False Positive Rate ◽  
Hormone Deficiency ◽  
Provocative Test ◽  
Definitive Evidence ◽  
Gh Secretion ◽  
Igf I ◽  
Igfbp 3

GH stimulation tests are widely used in the diagnosis of GH deficiency (GHD), although they are associated with a high false positive rate. Serum IGF-I levels are monitored during GH replacement treatment in subjects with GH deficiency (GHD) to guide GH dose adjustment and to minimize occurrence of GHrelated side-effects. The need for reliance on provocative testing is based on evidence that the evaluation of spontaneous growth hormone (GH) secretion over 24 hours and the measurement of IGF-I and IGFBP-3 levels do not distinguish between normal and GHD subjects. Regarding IGF-I, it has been demonstrated that very low levels in patients highly suspected for GHD (i.e., patients with childhood-onset, severe GHD, or with multiple hypopituitarism acquired in adulthood) may be considered definitive evidence for severe GHD obviating the need for provocative tests. However, normal IGF-I levels do not rule out severe GHD and therefore adults suspected for GHD and with normal IGF-I levels must undergo a provocative test of GH secretion. We hereby review the various literatures at disposal justifying the use of IGF-1 and IGBP3 for diagnosis of growth hormone deficiency.Data Source: We searched PUBMED and MEDLINE database for relevant articles including key words. References of each article were further reviewed for final synthesis of the manuscript.J Nepal Paediatr Soc 2012;32(2):154-162 doi: http://dx.doi.org/10.3126/jnps.v32i2.5342

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

1994 ◽  
Vol 131 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Yukihiro Hasegawa ◽  
Tomonobu Hasegawa ◽  
Taiji Aso ◽  
Shinobu Kotoh ◽  
Osamu Nose ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Hormone Deficiency ◽  
Insulin Like Growth Factor ◽  
Normal Children ◽  
Gh Treatment ◽  
Factor Binding ◽  
Short Children ◽  
Igf I ◽  
Igfbp 3

Hasegawa Y, Hasegawa T, Aso T, Kotoh S, Nose 0, Ohyama Y, Araki K, Tanaka T, Saisyo S, Yokoya S, Nishi Y, Miyamoto S, Sasaki N, Kurimoto F, Stene M, Tsuchiya Y, Clinical utility of insulin-like growth factor binding protein-3 in the evaluation and treatment of short children with suspected growth hormone deficiency. Eur J Endocrinol 1994;131:27–32. ISSN 0804–4643 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 poststimulation GH < 5 μg/l. The partial GHD group (N = 49) had post-stimulation GH peaks of > 5 μg/l but < 10 μg/l. The normal children with short stature (N = 103) had post-stimulation GH peaks > 10 μg/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. The incremental growth velocity during treatment correlated significantly with the pretreatment IGFBP-3 sd score (N = 46 r = –0.80, p < 0.005). The baseline IGFBP-3 sd score for all subjects correlated (N = 171, r = 0.51 p < 0.0001) with height. These data suggest that IGFBP-3 may reflect GH secretion status in most children being evaluated for GHD and that a low pretreatment IGFBP-3 sd score predicts improved growth during the first year of GH treatment. Yukihiro Hasegawa, Division of Endocrinology and Metabolism, Tokyo Metropolitan Kiyose Children's Hospital, 1-3-1 Umezono, Kiyose, Tokyo 204, Japan

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