Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency?

S. Cianfarani, S. Boemi, A. Spagnoli, M. Cappa, G. Argiro, F. Vaccaro, M. L. Manca Bitti, B. Boscherini

Research output: Contribution to journalArticle

Abstract

Objective - The measurement of serum immunoreactive IGFBP-3 levels has been proposed as a screening test to identify children with growth hormone deficiency (GHD). We tested the sensitivity and specificity of the IGFBP-3 assessment in comparison with the measurement of IGF-I. Design - We assessed the IGFBP-3 and IGF-I circulating levels In normal subjects and patients with GHD or idiopathic short stature (ISS). Patients - Eighty-two normal subjects, 16 GHD, and 10 children with ISS were studied. Controls were divided into three age groups: group A, 1-4 years (n = 16); group B, 5-9 years (n = 35), and group C, 10-14 years (n = 31). Measurements - All subjects underwent standard anthropometry. in short patients, GH secretory status was assessed by clonidine and arginine stimulation tests. IGFBP-3 and IGF-I circulating levels were measured by radioimmunoassay. Results - IGFBP-3 and IGF-I levels were closely related (r = 0.51, P <0.0001) and IGFBP-3 was less age dependent than IGF-I (r = 0.57, P <0.02 vs r = 0.64, P = 0.0001). Sensitivity (true positive ratio) and specificity (true negative ratio) of IGFBP-3 measurement were 50 and 92% respectively, whereas sensitivity and specificity of IGF-I assessment were 75 and 90% respectively. Below the age of 5 years, sensitivity was 20% for IGFBP-3 and 40% for IGF-I; specificity was 94% for IGFBP-3 and 88% for IGF-I. Conclusions - IGFBP-3 measurement had poor sensitivity in detecting growth hormone deficient patients, offering no diagnostic advantage over IGF-I, even in the first years of life, although, due to the high specificity, the finding of subnormal levels of IGFBP-3 was strongly suggestive of growth hormone deficiency. The presence of low IGFBP-3 and IGF-I levels in a short child with normal GH response to provocative tests should prompt further investigations, such as the determination of spontaneous GH secretion or assessment of the GH binding proteins together with an IGF-I and/or IGFBP-3 generation test, in order to identify neurosecretory dysfunction or GH receptor deficiency. Finally, we believe that there is no definitive test for diagnosing or excluding growth hormone deficiency and detailed analysis of the results of endocrine tests, clinical findings and other laboratory and radiological information is necessary to maximize diagnostic accuracy.

Original languageEnglish
Pages (from-to)43-47
Number of pages5
JournalClinical Endocrinology
Volume43
Issue number1
Publication statusPublished - 1995

Fingerprint

Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor I
Growth Hormone
Sensitivity and Specificity
Anthropometry
Clonidine
Radioimmunoassay
Arginine

ASJC Scopus subject areas

  • Endocrinology

Cite this

Cianfarani, S., Boemi, S., Spagnoli, A., Cappa, M., Argiro, G., Vaccaro, F., ... Boscherini, B. (1995). Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency? Clinical Endocrinology, 43(1), 43-47.

Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency? / Cianfarani, S.; Boemi, S.; Spagnoli, A.; Cappa, M.; Argiro, G.; Vaccaro, F.; Manca Bitti, M. L.; Boscherini, B.

In: Clinical Endocrinology, Vol. 43, No. 1, 1995, p. 43-47.

Research output: Contribution to journalArticle

Cianfarani, S, Boemi, S, Spagnoli, A, Cappa, M, Argiro, G, Vaccaro, F, Manca Bitti, ML & Boscherini, B 1995, 'Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency?', Clinical Endocrinology, vol. 43, no. 1, pp. 43-47.
Cianfarani, S. ; Boemi, S. ; Spagnoli, A. ; Cappa, M. ; Argiro, G. ; Vaccaro, F. ; Manca Bitti, M. L. ; Boscherini, B. / Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency?. In: Clinical Endocrinology. 1995 ; Vol. 43, No. 1. pp. 43-47.
@article{a652de6ba23045af96934cdd7de5e5d4,
title = "Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency?",
abstract = "Objective - The measurement of serum immunoreactive IGFBP-3 levels has been proposed as a screening test to identify children with growth hormone deficiency (GHD). We tested the sensitivity and specificity of the IGFBP-3 assessment in comparison with the measurement of IGF-I. Design - We assessed the IGFBP-3 and IGF-I circulating levels In normal subjects and patients with GHD or idiopathic short stature (ISS). Patients - Eighty-two normal subjects, 16 GHD, and 10 children with ISS were studied. Controls were divided into three age groups: group A, 1-4 years (n = 16); group B, 5-9 years (n = 35), and group C, 10-14 years (n = 31). Measurements - All subjects underwent standard anthropometry. in short patients, GH secretory status was assessed by clonidine and arginine stimulation tests. IGFBP-3 and IGF-I circulating levels were measured by radioimmunoassay. Results - IGFBP-3 and IGF-I levels were closely related (r = 0.51, P <0.0001) and IGFBP-3 was less age dependent than IGF-I (r = 0.57, P <0.02 vs r = 0.64, P = 0.0001). Sensitivity (true positive ratio) and specificity (true negative ratio) of IGFBP-3 measurement were 50 and 92{\%} respectively, whereas sensitivity and specificity of IGF-I assessment were 75 and 90{\%} respectively. Below the age of 5 years, sensitivity was 20{\%} for IGFBP-3 and 40{\%} for IGF-I; specificity was 94{\%} for IGFBP-3 and 88{\%} for IGF-I. Conclusions - IGFBP-3 measurement had poor sensitivity in detecting growth hormone deficient patients, offering no diagnostic advantage over IGF-I, even in the first years of life, although, due to the high specificity, the finding of subnormal levels of IGFBP-3 was strongly suggestive of growth hormone deficiency. The presence of low IGFBP-3 and IGF-I levels in a short child with normal GH response to provocative tests should prompt further investigations, such as the determination of spontaneous GH secretion or assessment of the GH binding proteins together with an IGF-I and/or IGFBP-3 generation test, in order to identify neurosecretory dysfunction or GH receptor deficiency. Finally, we believe that there is no definitive test for diagnosing or excluding growth hormone deficiency and detailed analysis of the results of endocrine tests, clinical findings and other laboratory and radiological information is necessary to maximize diagnostic accuracy.",
author = "S. Cianfarani and S. Boemi and A. Spagnoli and M. Cappa and G. Argiro and F. Vaccaro and {Manca Bitti}, {M. L.} and B. Boscherini",
year = "1995",
language = "English",
volume = "43",
pages = "43--47",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Is IGF binding protein-3 assessment helpful for the diagnosis of GH deficiency?

AU - Cianfarani, S.

AU - Boemi, S.

AU - Spagnoli, A.

AU - Cappa, M.

AU - Argiro, G.

AU - Vaccaro, F.

AU - Manca Bitti, M. L.

AU - Boscherini, B.

PY - 1995

Y1 - 1995

N2 - Objective - The measurement of serum immunoreactive IGFBP-3 levels has been proposed as a screening test to identify children with growth hormone deficiency (GHD). We tested the sensitivity and specificity of the IGFBP-3 assessment in comparison with the measurement of IGF-I. Design - We assessed the IGFBP-3 and IGF-I circulating levels In normal subjects and patients with GHD or idiopathic short stature (ISS). Patients - Eighty-two normal subjects, 16 GHD, and 10 children with ISS were studied. Controls were divided into three age groups: group A, 1-4 years (n = 16); group B, 5-9 years (n = 35), and group C, 10-14 years (n = 31). Measurements - All subjects underwent standard anthropometry. in short patients, GH secretory status was assessed by clonidine and arginine stimulation tests. IGFBP-3 and IGF-I circulating levels were measured by radioimmunoassay. Results - IGFBP-3 and IGF-I levels were closely related (r = 0.51, P <0.0001) and IGFBP-3 was less age dependent than IGF-I (r = 0.57, P <0.02 vs r = 0.64, P = 0.0001). Sensitivity (true positive ratio) and specificity (true negative ratio) of IGFBP-3 measurement were 50 and 92% respectively, whereas sensitivity and specificity of IGF-I assessment were 75 and 90% respectively. Below the age of 5 years, sensitivity was 20% for IGFBP-3 and 40% for IGF-I; specificity was 94% for IGFBP-3 and 88% for IGF-I. Conclusions - IGFBP-3 measurement had poor sensitivity in detecting growth hormone deficient patients, offering no diagnostic advantage over IGF-I, even in the first years of life, although, due to the high specificity, the finding of subnormal levels of IGFBP-3 was strongly suggestive of growth hormone deficiency. The presence of low IGFBP-3 and IGF-I levels in a short child with normal GH response to provocative tests should prompt further investigations, such as the determination of spontaneous GH secretion or assessment of the GH binding proteins together with an IGF-I and/or IGFBP-3 generation test, in order to identify neurosecretory dysfunction or GH receptor deficiency. Finally, we believe that there is no definitive test for diagnosing or excluding growth hormone deficiency and detailed analysis of the results of endocrine tests, clinical findings and other laboratory and radiological information is necessary to maximize diagnostic accuracy.

AB - Objective - The measurement of serum immunoreactive IGFBP-3 levels has been proposed as a screening test to identify children with growth hormone deficiency (GHD). We tested the sensitivity and specificity of the IGFBP-3 assessment in comparison with the measurement of IGF-I. Design - We assessed the IGFBP-3 and IGF-I circulating levels In normal subjects and patients with GHD or idiopathic short stature (ISS). Patients - Eighty-two normal subjects, 16 GHD, and 10 children with ISS were studied. Controls were divided into three age groups: group A, 1-4 years (n = 16); group B, 5-9 years (n = 35), and group C, 10-14 years (n = 31). Measurements - All subjects underwent standard anthropometry. in short patients, GH secretory status was assessed by clonidine and arginine stimulation tests. IGFBP-3 and IGF-I circulating levels were measured by radioimmunoassay. Results - IGFBP-3 and IGF-I levels were closely related (r = 0.51, P <0.0001) and IGFBP-3 was less age dependent than IGF-I (r = 0.57, P <0.02 vs r = 0.64, P = 0.0001). Sensitivity (true positive ratio) and specificity (true negative ratio) of IGFBP-3 measurement were 50 and 92% respectively, whereas sensitivity and specificity of IGF-I assessment were 75 and 90% respectively. Below the age of 5 years, sensitivity was 20% for IGFBP-3 and 40% for IGF-I; specificity was 94% for IGFBP-3 and 88% for IGF-I. Conclusions - IGFBP-3 measurement had poor sensitivity in detecting growth hormone deficient patients, offering no diagnostic advantage over IGF-I, even in the first years of life, although, due to the high specificity, the finding of subnormal levels of IGFBP-3 was strongly suggestive of growth hormone deficiency. The presence of low IGFBP-3 and IGF-I levels in a short child with normal GH response to provocative tests should prompt further investigations, such as the determination of spontaneous GH secretion or assessment of the GH binding proteins together with an IGF-I and/or IGFBP-3 generation test, in order to identify neurosecretory dysfunction or GH receptor deficiency. Finally, we believe that there is no definitive test for diagnosing or excluding growth hormone deficiency and detailed analysis of the results of endocrine tests, clinical findings and other laboratory and radiological information is necessary to maximize diagnostic accuracy.

UR - http://www.scopus.com/inward/record.url?scp=0029033051&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029033051&partnerID=8YFLogxK

M3 - Article

C2 - 7543832

AN - SCOPUS:0029033051

VL - 43

SP - 43

EP - 47

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 1

ER -