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Use of insulin-like growth factor-binding protein-2 (IGFBP-2), IGFBP-3, and IGF-I for assessing growth hormone status in short children. 1993

W J Smith, and T J Nam, and L E Underwood, and W H Busby, and A Celnicker, and D R Clemmons
Department of Medicine and Pediatrics, University of North Carolina, Chapel Hill 27599.

Insulin-like growth factor-binding protein-2 and -3 (IGFBP-2 and -3) are members of a family of proteins that are present in extracellular fluids and bind IGF-I and -II. IGFBP-2 is regulated differently from IGF-I and IGFBP-3, because its serum concentrations are elevated in some adults with GH deficiency (GHD), whereas IGF-I and IGFBP-3 concentrations are usually decreased. The purposes of this study were to define the normal range of IGFBP-2 concentrations in children, to determine its efficacy in the diagnosis of GHD, and to compare the diagnostic value of measurements of the serum GH response to provocative testing with results of measurements of IGFBP-2, IGFBP-3, and IGF-I. Mean serum IGFBP-2 concentrations ranged from 263 +/- 101 ng/mL (mean +/- SD) during infancy to 136 +/- 38 ng/mL in normal 15- to 18-yr-olds (P < 0.001), whereas IGFBP-3 increased from 1211 +/- 384 to 2781 +/- 382 ng/mL in the same age groups. Thirty-nine of 49 children with GHD and low IGF-I values (serum GH response, < or = 1 ng/mL after 2 provocative tests) had serum IGFBP-2 concentrations that were greater than 2 SD above their corresponding age-adjusted means. In contrast all 49 of these children had IGFBP-3 values that were below normal for age. Because serum IGFBP-2 concentrations are regulated by GH directly and not through IGF-I, the IGFBP-2 to IGF-I ratio was used to determine whether it improved diagnostic accuracy. Fifty of 57 GH-deficient children had IGFBP-2/IGF-I ratios that were greater than 2 SD above the mean. This included 48 of 49 children with low IGF-I and 2 of 8 children with normal IGF-I. Fifty-three of the 57 children with GHD had decreased IGFBP-3 values. Among 23 children with idiopathic short stature (ISS) who had normal responses to GH stimulation testing (serum GH, > 10 ng/mL), 7 had low IGF-I values. Of the 7, all had an increased IGFBP-2/IGF-I ratio and a low IGFBP-3 level. Of the remaining 16 children with normal IGF-I, 13 had a normal IGFBP-2/IGF-I ratio and normal IGFBP-3 values. Three had low IGFBP-3 and an increased IGFBP-2/IGF-I ratio. In 76% of the 80 short-statured patients studied, there was concordance among serum GH responses to provocative tests, IGF-I, IGFBP-2/IGF-I ratio, and IGFBP-3.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007334 Insulin-Like Growth Factor I A well-characterized basic peptide believed to be secreted by the liver and to circulate in the blood. It has growth-regulating, insulin-like, and mitogenic activities. This growth factor has a major, but not absolute, dependence on GROWTH HORMONE. It is believed to be mainly active in adults in contrast to INSULIN-LIKE GROWTH FACTOR II, which is a major fetal growth factor. IGF-I,Somatomedin C,IGF-1,IGF-I-SmC,Insulin Like Growth Factor I,Insulin-Like Somatomedin Peptide I,Insulin Like Somatomedin Peptide I
D008297 Male Males
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D001827 Body Height The distance from the sole to the crown of the head with body standing on a flat surface and fully extended. Body Heights,Height, Body,Heights, Body
D002352 Carrier Proteins Proteins that bind or transport specific substances in the blood, within the cell, or across cell membranes. Binding Proteins,Carrier Protein,Transport Protein,Transport Proteins,Binding Protein,Protein, Carrier,Proteins, Carrier
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006130 Growth Disorders Deviations from the average values for a specific age and sex in any or all of the following: height, weight, skeletal proportions, osseous development, or maturation of features. Included here are both acceleration and retardation of growth. Stunted Growth,Stunting,Disorder, Growth,Growth Disorder,Growth, Stunted,Stuntings

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