Jasper H, Pennisi P, Vitale M, Mella A, Ropelato G, Chervin A
Division of Endocrinology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.
J Endocrinol Invest. 1999 Jan;22(1):29-34. doi: 10.1007/BF03345475.
To facilitate the estimation of acromegalic activity a prospective study was done comparing, against a clinical score, the effectiveness of serum IGF-I, IGFBP3 and the IGF-I/IGFBP3 molar ratio. Sixty nine observations were distributed in three groups: Group I=patients before surgery; group II=patients improved but still clinically active; group III=patients clinically inactive. Suppression of serum GH levels one hour after an oral glucose load was in agreement with the clinical score in 21/22 observations. Increases in serum IGF-I and IGFBP3 levels were similarly frequent: both 100% in group I, 80% and 95% in group II, 9% and 36% in group III, respectively. The frequency of abnormal molar ratios was 95%, 40% and 0% in the same groups. Log IGF-I, log IGFBP3, and log molar ratio correlated significantly with the clinical scores (r=0.873, r=0.692, and r=0.829, respectively).
The IGF-I/IGFBP3 molar ratio was not better than either IGF-I or IGFBP3 in detecting activity in the three groups of patients studied. Both IGF-I and IGFBP3 appear comparably useful for the diagnosis and follow-up of acromegalic patients. Since IGF-I is a more biologically meaningful parameter it might be preferable.
为便于评估肢端肥大症的活动情况，开展了一项前瞻性研究，比较血清胰岛素样生长因子-I（IGF-I）、胰岛素样生长因子结合蛋白3（IGFBP3）及IGF-I/IGFBP3摩尔比相对于临床评分的有效性。69次观察结果分为三组：第一组=手术前患者；第二组=病情改善但仍有临床活动的患者；第三组=临床无活动的患者。口服葡萄糖负荷后1小时血清生长激素（GH）水平的抑制情况与22次观察中的21次临床评分一致。血清IGF-I和IGFBP3水平升高的情况同样常见：第一组均为100%，第二组分别为80%和95%，第三组分别为9%和36%。相同组中异常摩尔比的频率分别为95%、40%和0%。Log IGF-I、Log IGFBP3和Log摩尔比与临床评分显著相关（分别为r = 0.873、r = 0.692和r = 0.829）。
在所研究的三组患者中，IGF-I/IGFBP3摩尔比在检测活动方面并不优于IGF-I或IGFBP3。IGF-I和IGFBP3在肢端肥大症患者的诊断和随访中似乎同样有用。由于IGF-I是一个更具生物学意义的参数，可能更可取。
