title: IGF-I and IGF-binding protein-3 measurements on filter paper blood spots in children and adolescents on GH treatment: use in monitoring and as markers of growth performance.
abstract: OBJECTIVE
  In childhood an appropriate response to GH treatment is achieved by titration of growth response against dose administered, with careful observation for side-effects. In order to evaluate the potential use of IGF monitoring in children treated with GH, a cross-sectional study has been carried in 215 children and adolescents (134 with GH deficiency (GHD), 54 with Turner syndrome (TS) and 27 with non-GHD growth disorders) treated with GH for 0.2-13.7 years.
  
  
  METHODS
  IGF-I and IGF-binding protein-3 (IGFBP-3) were measured in ELISAs, using dried capillary blood collected onto filter papers. Results were expressed as the mean S.D. range (SDS). Values of either analyte < -2 or > +2 SDS were considered abnormal.
  
  
  RESULTS
  IGF-I and IGFBP-3 SDS were higher in the TS and non-GHD groups (mean +0.01 and +0.1 respectively) than in those with GHD (mean value -0.6). Nineteen per cent of the IGF-I values (13% low, 6% high) and 12% of IGFBP-3 values were abnormal (10% low, 2% high). Abnormalities, either low or high, were most common in the GHD group. There was a weak but significant relationship between change in height SDS over the Year up to the time of sampling in the whole group and IGF-I SDS. Satisfactory growth performance (+0.5>change in height SDS> -0.5) was found in those with high (7.2%), normal (60%) and low (9.3%) IGF-I levels. Overall, it was estimated that 26% of the tests would indicate that an adjustment to GH dose (up in 18% and down in 8%) could be considered.
  
  
  CONCLUSIONS
  From this cross-sectional study of IGF monitoring across a broad range of diagnoses and ages, it can be concluded that the majority of children on GH have normal levels of IGF-I and IGFBP-3, but 26% of tests could suggest that a change of GH dose should be considered. Regular monitoring of IGF-I and IGFBP-3 should be considered in any child on GH treatment.
authors.affiliation: Academic Unit of Child Health, Royal Manchester Children's Hospital, Manchester M27 4HA, UK.
authors.forename: U
authors.initials: U
authors.lastname: Das
authors.forename: A J
authors.initials: AJ
authors.lastname: Whatmore
authors.forename: J
authors.initials: J
authors.lastname: Khosravi
authors.forename: J K H
authors.initials: JK
authors.lastname: Wales
authors.forename: G
authors.initials: G
authors.lastname: Butler
authors.forename: M S
authors.initials: MS
authors.lastname: Kibirige
authors.forename: A
authors.initials: A
authors.lastname: Diamandi
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: L
authors.initials: L
authors.lastname: Patel
authors.forename: C M
authors.initials: CM
authors.lastname: Hall
authors.forename: D A
authors.initials: DA
authors.lastname: Price
authors.forename: P E
authors.initials: PE
authors.lastname: Clayton
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006130:Growth Disorders / Q000097:blood* / Q000188:drug therapy*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I