title: Diagnosis of idiopathic growth hormone deficiency: contributions of data on the acid-labile subunit, insulin-like growth factor (IGF)-I and-II, and IGF binding protein-3.
abstract: The diagnosis of non-organic growth hormone (GH) deficiency (GHD) remains difficult.
  
  
  OBJECTIVE
  To evaluate the value of measuring plasma insulin-like growth factor (IGF)-I and -II, IGF binding protein-3 (IGFBP-3) and acid-labile subunit (ALS) as criteria for diagnosing GHD.
  
  
  METHODS
  120 prepubertal patients having at least one of the main auxological criteria defined by the GH Research Society for initiating GH exploration were classified as (1) certain GHD (n = 40), (2) transient GHD (n = 18), (3) idiopathic short stature (n = 27), or (4) extreme short stature (n = 35).
  
  
  RESULTS
  All the patients with certain GHD had low (< or = -2 z-score) plasma concentrations of IGF-I and ALS, but only 35.1% had low IGF-II, and 48.6% had low IGFBP-3. All the patients but three (83.3%) with transient GHD had low IGF-I, but only 44.4% had low ALS, and only one had low IGF-II or IGFBP-3. The data for patients with idiopathic and extreme short stature and normal GH peak were similar to each other and to those for patients with transient GHD, except that IGF-I was less frequently low (49.2%, p <0.05).
  
  
  CONCLUSIONS
  All the patients with certain GHD had both IGF-I and ALS z-scores < or = -2, unlike those with transient GHD, and idiopathic or extreme short stature. Almost all the patients with short stature and normal GH peak had normal serum IGF-II and IGFBP-3 concentrations.
authors.affiliation: Service d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Trivin
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: Guillaume
authors.initials: G
authors.lastname: Aubertin
authors.forename: Ethel
authors.initials: E
authors.lastname: Lawson-Body
authors.forename: Luis
authors.initials: L
authors.lastname: Adan
authors.forename: Raja
authors.initials: R
authors.lastname: Brauner
mesh_terms: D001827:Body Height; D002352:Carrier Proteins / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004393:Dwarfism, Pituitary / Q000175:diagnosis*; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D007335:Insulin-Like Growth Factor II; D008297:Male; D011506:Proteins / Q000032:analysis*; D012189:Retrospective Studies; D013223:Statistics as Topic
chemical_list: D002352:Carrier Proteins; D006023:Glycoproteins; C035170:IGF2 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D011506:Proteins; C075944:insulin-like growth factor binding protein, acid labile subunit; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II