Diagnostic Value of Serum Acid-Labile Subunit Alone and in combination with IGF-I and IGFBP-3 in the Diagnosis of Growth Hormone Deficiency.
Adolescent
Austria
Biomarkers
/ blood
Carrier Proteins
/ blood
Child
Child, Preschool
Diagnostic Techniques, Endocrine
Dwarfism, Pituitary
/ blood
Female
Glycoproteins
/ blood
Human Growth Hormone
/ deficiency
Humans
Insulin-Like Growth Factor Binding Protein 3
/ blood
Insulin-Like Growth Factor I
/ analysis
Male
Predictive Value of Tests
Reference Values
Retrospective Studies
Acid-labile subunit
Growth hormone deficiency
IGF-binding protein-3
Insulin-like growth factor I
Journal
Hormone research in paediatrics
ISSN: 1663-2826
Titre abrégé: Horm Res Paediatr
Pays: Switzerland
ID NLM: 101525157
Informations de publication
Date de publication:
2020
2020
Historique:
received:
11
05
2020
accepted:
16
10
2020
pubmed:
21
12
2020
medline:
27
10
2021
entrez:
20
12
2020
Statut:
ppublish
Résumé
The acid-labile subunit (ALS) is a crucial factor in the tertiary complex. IGF-I and IGFBP-3 are routinely measured during the diagnostic work-up for growth hormone deficiency (GHD). The aim of the study is to evaluate the relevance of serum ALS as an additional biomarker in the diagnosis of GHD. Ninety-one children undergoing standard diagnostic work-up for GHD were included in this retrospective study. Inclusion criteria were evidence-based auxological cutoffs, IGF-I and IGFBP-3 <-2 SDS at first presentation, at least 1 growth hormone (GH) stimulation test, and IGF-I, IGFBP-3, and ALS measurements on the same day. Statistical analysis was performed by ROC as well as by odds ratio calculations. Forty-seven of 90 participants presented with peak GH values under the cutoff of 7 ng/mL. AUC from a model containing only IGF-I was 0.76 and 0.68 when using only ALS. A model containing IGF-I, IGFBP-3, and ALS (AUC = 0.77) did not improve the result compared to the combination of IGF-I/IGFBP-3 (0.77) or IGF-I/ALS (0.76). Furthermore, the variation in the outcome (GH peak </≥7) explained by IGF-I only amounts to 20.4%, while that explained by IGFBP-3 and ALS is only 10.6 and 7.8%, respectively. The sensitivity to diagnose GHD at respective concentrations of -2.0 SDS was 48% for IGF-I, 38% for IGFBP-3, and only 8% for ALS. Determination of serum ALS alone or in combination with IGF-I and IGFBP-3 did not improve definition of biochemical GHD in a cohort of short children and adolescents with suspected growth disorder. However, performance of IGFBP-3 in this context was not statistically superior to ALS.
Sections du résumé
BACKGROUND
BACKGROUND
The acid-labile subunit (ALS) is a crucial factor in the tertiary complex. IGF-I and IGFBP-3 are routinely measured during the diagnostic work-up for growth hormone deficiency (GHD). The aim of the study is to evaluate the relevance of serum ALS as an additional biomarker in the diagnosis of GHD.
METHODS
METHODS
Ninety-one children undergoing standard diagnostic work-up for GHD were included in this retrospective study. Inclusion criteria were evidence-based auxological cutoffs, IGF-I and IGFBP-3 <-2 SDS at first presentation, at least 1 growth hormone (GH) stimulation test, and IGF-I, IGFBP-3, and ALS measurements on the same day. Statistical analysis was performed by ROC as well as by odds ratio calculations.
RESULTS
RESULTS
Forty-seven of 90 participants presented with peak GH values under the cutoff of 7 ng/mL. AUC from a model containing only IGF-I was 0.76 and 0.68 when using only ALS. A model containing IGF-I, IGFBP-3, and ALS (AUC = 0.77) did not improve the result compared to the combination of IGF-I/IGFBP-3 (0.77) or IGF-I/ALS (0.76). Furthermore, the variation in the outcome (GH peak </≥7) explained by IGF-I only amounts to 20.4%, while that explained by IGFBP-3 and ALS is only 10.6 and 7.8%, respectively. The sensitivity to diagnose GHD at respective concentrations of -2.0 SDS was 48% for IGF-I, 38% for IGFBP-3, and only 8% for ALS.
CONCLUSION
CONCLUSIONS
Determination of serum ALS alone or in combination with IGF-I and IGFBP-3 did not improve definition of biochemical GHD in a cohort of short children and adolescents with suspected growth disorder. However, performance of IGFBP-3 in this context was not statistically superior to ALS.
Identifiants
pubmed: 33341813
pii: 000512336
doi: 10.1159/000512336
doi:
Substances chimiques
Biomarkers
0
Carrier Proteins
0
Glycoproteins
0
IGFBP3 protein, human
0
Insulin-Like Growth Factor Binding Protein 3
0
insulin-like growth factor binding protein, acid labile subunit
0
Human Growth Hormone
12629-01-5
Insulin-Like Growth Factor I
67763-96-6
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
371-379Informations de copyright
© 2020 S. Karger AG, Basel.