Assessment of serum IGF-I concentrations in the diagnosis of isolated childhood-onset GH deficiency: a proposal of the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP/ISPED).
The diagnosis of GH deficiency (GHD) is based on the measurement of peak GH responses to pharmacological stimuli. Pharmacological stimuli, however, lack precision, accuracy, are not reproducible, are invasive, non-physiological and some may even be hazardous. Furthermore, different GH commercial assays used to measure GH in serum yield results that may differ considerably. In contrast to GH, IGF-I can be measured on a single, randomly-obtained blood sample. A review of the available data indicates that IGF-I measurement in the diagnosis of childhood-onset isolated GHD has a specificity of up to 100%, with a sensitivity ranging from about 70 to 90%. We suggest an algorithm in which circulating levels of IGF-I together with the evaluation of auxological data, such as growth rate and growth, may be used to assess the likelihood of GHD in pre-pubertal children.
Federico
G
G
Department of Pediatrics, Azienda Ospedaliero-Universitaria Pisana, 56125 Pisa, Italy. g.federico@med.unipi.it
Street
M E
ME
Maghnie
M
M
Caruso-Nicoletti
M
M
Loche
S
S
Bertelloni
S
S
Cianfarani
S
S
D017668:Age of Onset; D000465:Algorithms; D015415:Biomarkers / Q000097:blood*; D002648:Child; D004393:Dwarfism, Pituitary / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D004704:Endocrinology / Q000592:standards*; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007558:Italy; D011627:Puberty / Q000097:blood; D012955:Societies, Medical / Q000592:standards*
D015415:Biomarkers; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I