Significance of Direct Confirmation of Growth Hormone Insensitivity for the Diagnosis of Primary IGF-I Deficiency
Open Access
- 15 January 2020
- journal article
- research article
- Published by MDPI AG in Journal of Clinical Medicine
- Vol. 9 (1), 240
- https://doi.org/10.3390/jcm9010240
Abstract
Primary insulin-like growth factor-I (IGF-I) deficiency is a synonym of growth hormone (GH) insensitivity (GHI), however the necessity of direct confirmation of GH resistance by IGF-I generation test (IGF-GT) is discussed. GHI may disturb intrauterine growth, nevertheless short children born small for gestational age (SGA) are treated with GH. We tested the hypothesis that children with appropriate birth size (AGA), height standard deviation score (SDS) <−3.0, GH peak in stimulation tests (stimGH) ≥10.0 µg/L, IGF-I <2.5 centile, and excluded GHI may benefit during GH therapy. The analysis comprised 21 AGA children compared with 6 SGA and 20 GH-deficient ones, with height SDS and IGF-I as in the studied group. All patients were treated with GH up to final height (FH). Height velocity, IGF-I, and IGF binding protein-3 (IGFBP-3) concentrations before and during first year of treatment were assessed. Effectiveness of therapy was better in GHD than in IGF-I deficiency (IGFD), with no significant difference between SGA and AGA groups. All but two AGA children responded well to GH. Pretreatment IGF-I and increase of height velocity (HV) during therapy but not the result of IGF-GT correlated with FH. As most AGA children with apparent severe IGFD benefit during GH therapy, direct confirmation of GHI seems necessary to diagnose true primary IGFD in them.Keywords
This publication has 50 references indexed in Scilit:
- Early diagnosis and treatment referral of children born small for gestational age without catch-up growth are critical for optimal growth outcomesInternational Journal of Pediatric Endocrinology, 2012
- DIAGNOSIS OF ENDOCRINE DISEASE: Limitations of the IGF1 generation test in children with short statureActa Endocrinologica, 2012
- Diagnosis of Growth Hormone DeficiencyPublished by S. Karger AG ,2010
- The continuum of growth hormone–IGF‐I axis defects causing short stature: diagnostic and therapeutic challengesClinical Endocrinology, 2010
- Prevalence of IGF1 deficiency in prepubertal children with isolated short statureActa Endocrinologica, 2009
- Continuous growth reference from 24thweek of gestation to 24 months by genderBMC Pediatrics, 2008
- Insulin-Like Growth Factor (IGF) Parameters and Tools for Efficacy: The IGF-I Generation Test in ChildrenHormone Research in Paediatrics, 2004
- Monitoring serum insulin‐like growth factor‐I (IGF‐I), IGF binding protein‐3 (IGFBP‐3), IGF‐I/IGFBP‐3 molar ratio and leptin during growth hormone treatment for disordered growthClinical Endocrinology, 2000
- Improvement of diagnostic criteria in growth hormone insensitivity syndrome: solutions and pitfallsActa Paediatrica, 1994
- The insulin‐like growth factor I generation test in the investigation of short statureActa Paediatrica, 1994