胰岛素样生长因子-I（IGF-I）和胰岛素样生长因子结合蛋白3（IGF-BP3）对诊断身材矮小儿童的生长激素缺乏症有用吗？

Are IGF-I and IGF-BP3 useful for diagnosing growth hormone deficiency in children of short stature?

作者信息

Galluzzi Fiorella, Quaranta Maria Rita, Salti Roberto, Saieva Calogero, Nanni Laura, Seminara Salvatore

机构信息

Paediatric Endocrinology Unit, Department of Paediatrics, University of Florence, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.

出版信息

J Pediatr Endocrinol Metab. 2010 Dec;23(12):1273-9. doi: 10.1515/jpem.2010.201.

DOI:10.1515/jpem.2010.201

PMID:21714461

Abstract

BACKGROUND

The diagnosis of growth hormone deficiency (GHD) is based on clinical and auxological characteristics combined with the results of growth hormone provocation tests.

AIM

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

目的

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。