The usefulness of serum insulin-like growth factor-1 (IGF-1) and insulin-
like growth factor binding protein-3 (IGFBP-3) for evaluation of children
with short stature
ประโยชน์ของระดับ serum insulin-like growth factor-1 (IGF-1) และ insulin-like
growth factor binding protein-3 (IGFBP-3) ในการประเมินเด็กตัวเตี้ย
Somchit Jaruratanasirikul, Assoc. Prof., D. of Pediatrics, F. of Medicine, PSU.
Kalaya Leethanaporn, D. of Radiology, F. of Medicine, PSU.
Hutcha Sriplung, Assoc. Prof., D. of Pathology, F. of Medicine, PSU.
Corresponding e-mail : jsomchit@ratree.psu.ac.th
Grant : Government Budget
Published : J Med Assoc Thai 2000, 83 : 619-626
Key words : growth hormone, insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), short stature
The diagnostic value of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) was studied in 24 growth hormone deficient (GHD) and 36
normal variant short stature (NVSS) children. The serum IGF-1 and IGFBP-3 concentrations were markedly below the 5th centile for chronological age in all 24 GHD children, but were in the low
normal range for age in most of NVSS children. The concentrations of IGF-1 and IGFBP-3 signifi-cantly correlated with peak GH concentration, height age, and bone age. To account for the age and
sex -dependency, IGF-1 and IGFBP-3 levels were transformed to standard deviation seore (SDS). Using the - 2 SDS as a cut-off level to differentiate between GHD and NVSS, the diagnostic value
of IGF-1, as well as IGFBP-3, showed sensitivity 100%, specificity 66.7%, and accuracy 80%. The combined use of IGF-1 and IGFBP-3 < -2 SDS improved the diagnostic value with sensitivity 100%, specificity 77.8%, and accuracy 86.7%. We concluded that the serum cencentrations of IGF-1 and IGFBP-3 could reflect endogenous GH secretion and could be used as a screening evaluation of GH status in short children.
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