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Limitations of the IGF-I generation test in children with short stature.
MedLine Citation:
PMID:  22048966     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The insulin-like growth factor-I (IGF-I) generation test (IGFGT) is often used during the assessment of suspected growth hormone (GH) insensitivity (GHI). We report the results of a survey undertaken in 2010 to determine the use of the IGFGT amongst members of the European Society for Paediatric Endocrinology (ESPE) to evaluate suspected GHI. The literature surrounding the usefulness and limitations of the IGFGT are reviewed, and recommendations provided for its use.Of 112 pediatric endocrinologists from 30 countries who responded to the survey, 91 (81%) reported that they had used the IGFGT in the previous 2 years; >10 IGFGT protocols were used. The IGFGT impacted treatment decisions for 97% of the respondents, and was a prerequisite for recombinant human IGF-1 (rhIGF-1) treatment for 45% of respondents. From a literature review, sensitivity of the IGFGT was evaluated as 80-85% in molecularly proven cases of GHI; specificity was ≤97%, depending on protocol. The positive predictive value of the IGFGT is likely to be low, as the frequency of normality is predictably higher than that of abnormality in GH signalling. Given the limitations of the IGFGT in the most severe cases of GHI syndrome (GHIS), the ability of the IGFGT to detect less severe GHIS is doubtful. In a pragmatic approach, the IGFGT may not be useful for the diagnosis of GHIS.
Authors:
Regis Coutant; Helmuth G Dörr; Helena Gleeson; Jesús Argente
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-2
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
R Coutant, Service d'Endocrinologie Pediatrique, Centre Hospitalier Universitaire Angers, Angers, 49033, France.
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