Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) Measurements in the Diagnosis of Growth Hormone Insufficiency and Comparison with IGF-I Measurements
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概要
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To analyze the utility of insulin-like growth factor binding protein-3 (IGFBP-3) radioimmunoassay in the diagnosis of GH insufficiency (GHI) and compare the results of IGFBP-3 and IGF-I, we measured IGF-I and IGFBP-3 in sera from normal children (n=309), short children (n=99) and patients with GHI (n=73). We divided the GHI group into two groups (complete and partial GHD) and divided all the patients into two groups depending upon age (less than and older than 10 years).<BR>The sensitivity of IGF-I for complete GHD (cGHD) was 80%, while the specificity for normal short children (NS) was 81%. The sensitivity of IGFBP-3 for cGHD was 93%, while the specificity for NS was 88%. In contrast, the sensitivities of IGF-I and IGFBP-3 for partial GHD (pGHD) were both only 43%. The poor discrimination between patients with pGHD and NS by using these two parameters may be the result of their relatively similar GH level, as compared to cGHD, or of the limitations of GH stimulation tests in the diagnosis of GHI.<BR>The specificities of IGF-I and IGFBP-3 for NS were high (82-92%) in children of all ages. The sensitivity of IGF-I for GHD at less than and older than 10 years old was 66% and 71%, respectively. The sensitivity of IGFBP-3 for GHI was good for children less than 10 years of age (84%) but poor for children older than 10 years (64%), because IGFBP-3 levels may also increase during puberty by mechanisms independent of the GH-IGF-I axis. Thus, in the younger chil-dren, the sensitivity for GHI of IGFBP-3 was higher than that of IGF-I.<BR>Finally, although nice correlation was observed between IGFBP-3 and IGF-I levels, some patients (both GHI and NS) had discordant results of IGFBP-3 and IGF-I either below or above the cutoff levels, possibly due to limitations of GHI diagnosis based upon GH stimulation tests.
- 日本小児内分泌学会の論文
日本小児内分泌学会 | 論文
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