Ann Pediatr Endocrinol Metab.  2020 Dec;25(4):240-247. 10.6065/apem.2040018.009.

Discriminatory performance of insulin-like growth factor 1 and insulin-like growth factor binding protein-3 by correlating values to chronological age, bone age, and pubertal status for diagnosis of isolated growth hormone deficiency

• Choi Yj
• Lee YJ
• Lee NY
• Lee SH
• Kim SK
• Ahn MB
• Kim SH
• Cho WK
• Cho KS
• Jung MH
• Suh BK

• KMID: 2510895
• DOI: http://doi.org/10.6065/apem.2040018.009

Abstract

Purpose
The discriminatory performance of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) was investigated by correlating their values with chronological age (CA), bone age (BA), and pubertal status (PS) for diagnosis of isolated growth hormone deficiency (IGHD).
Methods
We evaluated IGF-1 and IGFBP-3 levels in 310 short-stature subjects subdivided into 2 groups: IGHD (n=31) and non-IGHD (n=279). IGF-1 and IGFBP-3 were assayed using immune-radiometric assay and transformed into standard deviation score (SDS) according to CA, BA, and PS.
Results
The highest sensitivity was found in IGF-1-SDS for CA and IGFBP-3-SDS for CA (22.6% and 30.0%, respectively). The highest specificity was found in IGF-1-SDS for PS and IGFBP-3-SDS for PS (98.2% and 94.4%, respectively). Groups with the highest positive predictive values were IGF-1-SDS for BA and IGFBP-3-SDS for BA (10.9% and 5.1%, respectively). Highest negative predictive values were seen in IGF-1-SDS for CA and IGFBP-3-SDS for CA (98.4% and 98.4%, respectively).
Conclusion
IGF-1-SDS for CA, instead of IGF-1-SDS for BA or PS, could be used as a standard variable for IGHD screening. The sufficiently high specificity of IGF-1-SDS for PS suggests that this value is a useful tool for identification of IGHD.

Keyword

Insulin-like growth factor 1; Insulin-like growth factor binding protein-3; Isolated growth hormone deficiency; Sensitivity; Specificity; Chronological age; Bone age; Pubertal status

Figure

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  Fig. 1. Comparison of diagnostic value of IGF-1 and IGFBP-3 for isolated growth hormone deficiency. (A) Box-plot chart of IGF-1. (B) Box-plot chart of IGFBP-3. IGF-1, insulin-like growth factor 1; IGFBP-3, insulin-like growth factor binding protein 3; CA, chronological age; BA, bone age; PS, pubertal status; SDS, standard deviation score.

• 

  Fig. 2. Diagnostic performance of IGF-1 and IGFBP-3 for isolated growth hormone deficiency. (A) ROC plot of IGF-1. (B) ROC plot of IGFBP-3. IGF-1, insulin-like growth factor 1; IGFBP-3, insulin-like growth factor binding protein 3; CA, chronological age; BA, bone age; PS, pubertal status; SDS, standard deviation score; ROC, receiver operator characteristic; AUC, area under the curve.

Reference

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