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Open AccessArticle

Significance of Direct Confirmation of Growth Hormone Insensitivity for the Diagnosis of Primary IGF-I Deficiency

1
Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland
2
Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland
3
Department of Pediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland
4
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 93-338 Lodz, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 240; https://doi.org/10.3390/jcm9010240
Received: 15 December 2019 / Revised: 8 January 2020 / Accepted: 12 January 2020 / Published: 16 January 2020
(This article belongs to the Section Endocrinology & Metabolism)
Primary insulin-like growth factor-I (IGF-I) deficiency is a synonym of growth hormone (GH) insensitivity (GHI), however the necessity of direct confirmation of GH resistance by IGF-I generation test (IGF-GT) is discussed. GHI may disturb intrauterine growth, nevertheless short children born small for gestational age (SGA) are treated with GH. We tested the hypothesis that children with appropriate birth size (AGA), height standard deviation score (SDS) <−3.0, GH peak in stimulation tests (stimGH) ≥10.0 µg/L, IGF-I <2.5 centile, and excluded GHI may benefit during GH therapy. The analysis comprised 21 AGA children compared with 6 SGA and 20 GH-deficient ones, with height SDS and IGF-I as in the studied group. All patients were treated with GH up to final height (FH). Height velocity, IGF-I, and IGF binding protein-3 (IGFBP-3) concentrations before and during first year of treatment were assessed. Effectiveness of therapy was better in GHD than in IGF-I deficiency (IGFD), with no significant difference between SGA and AGA groups. All but two AGA children responded well to GH. Pretreatment IGF-I and increase of height velocity (HV) during therapy but not the result of IGF-GT correlated with FH. As most AGA children with apparent severe IGFD benefit during GH therapy, direct confirmation of GHI seems necessary to diagnose true primary IGFD in them. View Full-Text
Keywords: growth hormone (GH); GH insensitivity; insulin-like growth factor-I; IGF-I deficiency; short stature growth hormone (GH); GH insensitivity; insulin-like growth factor-I; IGF-I deficiency; short stature
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MDPI and ACS Style

Smyczyńska, J.; Smyczyńska, U.; Hilczer, M.; Stawerska, R.; Lewiński, A. Significance of Direct Confirmation of Growth Hormone Insensitivity for the Diagnosis of Primary IGF-I Deficiency. J. Clin. Med. 2020, 9, 240.

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