Shen Yi, Zhang Jian, Zhao Yanhong, Yan Yu, Liu Yanmei, Cai Jin
Department of Epidemiology and Medical Statistics, Nantong University, Nantong, Jiangsu, China,
Eur J Pediatr. 2015 Apr;174(4):419-27. doi: 10.1007/s00431-014-2406-3. Epub 2014 Sep 13.
Serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) are conventionally considered available for the diagnosis of growth hormone deficiency (GHD), but the results about their diagnostic values are inconsistent among some recent epidemiological studies. The aim of this study is to assess the diagnostic values of serum IGF-1 and IGFBP-3 for GHD by conducting a systematic review and meta-analysis. Studies on serum IGF-1 and IGFBP-3 used in GHD diagnosis were systematically searched from databases PubMed, EMBASE, and CNKI (up to December 2013). Characteristics of the studies and data were independently collected according to the inclusion criteria by two authors. The quality of included studies was assessed using quality assessment of diagnostic accuracy studies (QUADAS). Both sensitivity (SEN) and specificity (SPE) of IGF-1 and IGFBP-3 in GHD diagnosis were estimated on statistical software Meta-DiSc and Stata. A total of 12 studies were included for the final analysis. IGF-1 had SEN of 0.66, SPE of 0.69, positive likelihood ratio (PLR) of 2.48, negative likelihood ratio (NLR) of 0.51, area under the summary receiver operating characteristic curve (SROC) of 0.78, and Q* value of 0.72. Serum IGFBP-3 had SEN of 0.50, SPE of 0.79, PLR of 2.69, NLR of 0.64, area under SROC of 0.80, and Q* value of 0.73.
Serum IGF-1 and IGFBP-3 are useful for the diagnosis of GHD and can be utilized as auxiliary diagnosis indexes for provocative test.
血清胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）传统上被认为可用于生长激素缺乏症（GHD）的诊断，但近期一些流行病学研究中关于它们诊断价值的结果并不一致。本研究的目的是通过进行系统评价和荟萃分析来评估血清IGF-1和IGFBP-3对GHD的诊断价值。从PubMed、EMBASE和CNKI数据库（截至2013年12月）中系统检索用于GHD诊断的血清IGF-1和IGFBP-3的研究。两位作者根据纳入标准独立收集研究的特征和数据。使用诊断准确性研究的质量评估（QUADAS）来评估纳入研究的质量。在统计软件Meta-DiSc和Stata上估计IGF-1和IGFBP-3在GHD诊断中的敏感性（SEN）和特异性（SPE）。最终纳入12项研究进行分析。IGF-1的SEN为0.66，SPE为0.69，阳性似然比（PLR）为2.48，阴性似然比（NLR）为0.51，汇总受试者工作特征曲线（SROC）下面积为0.78，Q值为0.72。血清IGFBP-3的SEN为0.50，SPE为0.79，PLR为2.69，NLR为0.64，SROC下面积为0.80，Q值为0.73。
血清IGF-1和IGFBP-3对GHD的诊断有用，可作为激发试验的辅助诊断指标。
