Efficacy of insulin-like growth factor I levels in predicting the response to provocative growth hormone testing

Phillip Lee, D. M. Wilson, L. Rountree, R. L. Hintz, R. G. Rosenfeld

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Clinical testing of growth hormone (GH) sufficiency is a controversial area in endocrinology. Due to the episodic nature of endogenous GH secretion, diagnosis of GH deficiency has been defined as a failure to achieve normal GH levels in response to at least two stimuli. This testing is associated with significant patient morbidity and cost. We analyzed our experience over a 4-y period to determine whether clinical or biochemical variables could be used to predict the results of a specific GH testing procedure. Of 180 cases analyzed (67% male, mean age 8.89 ± 4.39 y, range neonate-16 y), eight cases had incomplete GH testing results. Of the remaining 172, 19 were GH deficient (GH level <7 ng/mL). Younger age, higher body mass index and a greater degree of bone age delay were characteristic of the GH-deficient population; however, none of these variables alone was of diagnostic utility. Serum IGF-I level was below the normal range for 81% of the GH deficient and 47% of the GH-sufficient children; and was the only single variable that provided a reasonable between-group distinction. Discriminant analysis resulted in development of a new variable, based on IGF-I z scores, chronologic age, degree of bone age delay, and body mass index, which would have allowed exclusion of GH deficiency without provocative testing for 58% of the GH sufficient population, whereas permitting the diagnosis of GH deficiency for all GH-deficient subjects. Our data are dependent on the IGF-I assay method and the clinical definition for GH deficiency; therefore, the calculated predictive values are not applicable to all clinical populations. However, our data provide a new perspective on the integration of IGF-I levels and clinical information in predicting GH sufficiency.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalPediatric Research
Volume27
Issue number1
StatePublished - 1990
Externally publishedYes

Fingerprint

Insulin-Like Growth Factor I
Growth Hormone
Body Mass Index
Population
Bone and Bones
Endocrinology
Discriminant Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Efficacy of insulin-like growth factor I levels in predicting the response to provocative growth hormone testing. / Lee, Phillip; Wilson, D. M.; Rountree, L.; Hintz, R. L.; Rosenfeld, R. G.

In: Pediatric Research, Vol. 27, No. 1, 1990, p. 45-51.

Research output: Contribution to journalArticle

Lee, P, Wilson, DM, Rountree, L, Hintz, RL & Rosenfeld, RG 1990, 'Efficacy of insulin-like growth factor I levels in predicting the response to provocative growth hormone testing', Pediatric Research, vol. 27, no. 1, pp. 45-51.
Lee, Phillip ; Wilson, D. M. ; Rountree, L. ; Hintz, R. L. ; Rosenfeld, R. G. / Efficacy of insulin-like growth factor I levels in predicting the response to provocative growth hormone testing. In: Pediatric Research. 1990 ; Vol. 27, No. 1. pp. 45-51.
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