Galluzzi Fiorella, Quaranta Maria Rita, Salti Roberto, Saieva Calogero, Nanni Laura, Seminara Salvatore
Paediatric Endocrinology Unit, Department of Paediatrics, University of Florence, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
J Pediatr Endocrinol Metab. 2010 Dec;23(12):1273-9. doi: 10.1515/jpem.2010.201.
The diagnosis of growth hormone deficiency (GHD) is based on clinical and auxological characteristics combined with the results of growth hormone provocation tests.
To evaluate the utility of IGF-I and IGF-BP3 serum levels in the diagnosis of GHD among children of short stature.
SUBJECTS/METHODS: We recruited 207 short pre-pubertal children and divided them into two groups. One group consisted of 70 children (mean age 7.93 +/- 2.35 SD) with a growth hormone (GH) response on two provocative tests of < or = 8 ng/ml, while the other group contained 137 children (mean age 7.92 +/- 2.11 SD) with a peak GH value of > 8 ng/ml. Serum IGF-1 and IGF-BP3 levels were determined in the two groups.
The difference in serum IGF-I between the two groups was not significant (p= 0.26), while the difference in IGF-BP3 between the two groups was statistically significant (p= 0.004). The performance of serum IGF-1 and IGF-BP3 as a diagnostic tool, expressed as AUC by ROC analyses, was quite low.
Neither IGF-I nor IGF-BP3 are an adequate substitute for the stimulus test in the diagnosis of growth hormone deficiency among children of short stature.
生长激素缺乏症（GHD）的诊断基于临床和体格学特征，并结合生长激素激发试验的结果。
评估血清胰岛素样生长因子-1（IGF-I）和胰岛素样生长因子结合蛋白3（IGF-BP3）水平在矮小儿童生长激素缺乏症诊断中的作用。
对象/方法：我们招募了207名青春期前矮小儿童，并将他们分为两组。一组由70名儿童（平均年龄7.93±2.35标准差）组成，这70名儿童在两项激发试验中的生长激素（GH）反应≤8 ng/ml，而另一组包含137名儿童（平均年龄7.92±2.11标准差），其生长激素峰值>8 ng/ml。测定两组儿童的血清IGF-1和IGF-BP3水平。
两组之间血清IGF-I的差异不显著（p = 0.26），而两组之间IGF-BP3的差异具有统计学意义（p = 0.004）。血清IGF-1和IGF-BP3作为诊断工具的性能，通过ROC分析以曲线下面积（AUC）表示，相当低。
在矮小儿童生长激素缺乏症的诊断中，IGF-I和IGF-BP3都不是刺激试验的合适替代方法。
