title: The effect of sports injury on insulin-like growth factor-I and type 3 procollagen: implications for detection of growth hormone abuse in athletes.
abstract: BACKGROUND
  A method to detect exogenously administered growth hormone (GH) based on the measurement of two GH-dependent markers, IGF-I and type 3 procollagen (P-III-P) has been proposed. Skeletal or soft tissue injury may alter these markers. Elevations in either of these proteins after injury might lead to a false accusation of doping with GH.
  
  
  OBJECTIVE
  The objective of the study was to assess the effect of musculoskeletal or soft tissue injury on IGF-I and P-III-P concentrations in amateur and elite athletes and assess the effect of injury on the proposed GH detection method.
  
  
  METHODS
  This was a longitudinal observational study after sporting injury.
  
  
  METHODS
  The study was conducted at Southampton General Hospital and British Olympic Medical Centre.
  
  
  METHODS
  Subjects included elite and amateur athletes after an injury.
  
  
  METHODS
  Interventions included measurement of IGF-I and P-III-P and application of the GH-2000 discriminant function score up to 84 d after an injury as well as classification of injury by type and severity.
  
  
  METHODS
  IGF-I and P-III-P concentration and ability to detect GH abuse in athletes without the risk of false accusation because of an injury were measured.
  
  
  RESULTS
  There was no change in IGF-I concentration after an injury. By contrast, P-III-P concentrations rose by 41.1 +/- 16.6%, reaching a peak around 14 d after an injury. The rise in P-III-P varied according to injury type and severity. This rise had a trivial effect on the GH-2000 discriminant function score, and no subject reached the threshold needed for a doping offense.
  
  
  CONCLUSIONS
  Although there was a rise in P-III-P after injury, this was insufficient to invalidate the GH-2000 detection method based on IGF-I and P-III-P concentrations.
authors.affiliation: The Institute of Developmental Sciences (IDS Building), MP887, University of Southampton, Southampton General Hospital, Tremona Road, Southampton United Kingdom.
authors.forename: Ioulietta
authors.initials: I
authors.lastname: Erotokritou-Mulligan
authors.forename: E Eryl
authors.initials: EE
authors.lastname: Bassett
authors.forename: Christiaan
authors.initials: C
authors.lastname: Bartlett
authors.forename: David
authors.initials: D
authors.lastname: Cowan
authors.forename: Cathy
authors.initials: C
authors.lastname: McHugh
authors.forename: Rick
authors.initials: R
authors.lastname: Seah
authors.forename: Benjamin
authors.initials: B
authors.lastname: Curtis
authors.forename: Victoria
authors.initials: V
authors.lastname: Wells
authors.forename: Kate
authors.initials: K
authors.lastname: Harrison
authors.forename: Peter H
authors.initials: PH
authors.lastname: Sönksen
authors.forename: Richard I G
authors.initials: RI
authors.lastname: Holt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000097:blood*; D024061:Collagen Type III / Q000097:blood*; D004300:Doping in Sports; D005260:Female; D017102:Fracture Healing; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000175:diagnosis*
chemical_list: D024061:Collagen Type III; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I