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.
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.
Trivin
Christine
C
Service d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, France.
Souberbielle
Jean-Claude
JC
Aubertin
Guillaume
G
Lawson-Body
Ethel
E
Adan
Luis
L
Brauner
Raja
R
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
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