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Diagnostic value of serum IGF-1 and IGFBP-3 in growth hormone deficiency: a systematic review with meta-analysis

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Abstract

Serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) are conventionally considered available for the diagnosis of growth hormone deficiency (GHD), but the results about their diagnostic values are inconsistent among some recent epidemiological studies. The aim of this study is to assess the diagnostic values of serum IGF-1 and IGFBP-3 for GHD by conducting a systematic review and meta-analysis. Studies on serum IGF-1 and IGFBP-3 used in GHD diagnosis were systematically searched from databases PubMed, EMBASE, and CNKI (up to December 2013). Characteristics of the studies and data were independently collected according to the inclusion criteria by two authors. The quality of included studies was assessed using quality assessment of diagnostic accuracy studies (QUADAS). Both sensitivity (SEN) and specificity (SPE) of IGF-1 and IGFBP-3 in GHD diagnosis were estimated on statistical software Meta-DiSc and Stata. A total of 12 studies were included for the final analysis. IGF-1 had SEN of 0.66, SPE of 0.69, positive likelihood ratio (PLR) of 2.48, negative likelihood ratio (NLR) of 0.51, area under the summary receiver operating characteristic curve (SROC) of 0.78, and Q* value of 0.72. Serum IGFBP-3 had SEN of 0.50, SPE of 0.79, PLR of 2.69, NLR of 0.64, area under SROC of 0.80, and Q* value of 0.73.

Conclusion: Serum IGF-1 and IGFBP-3 are useful for the diagnosis of GHD and can be utilized as auxiliary diagnosis indexes for provocative test.

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Abbreviations

AUC:

Area under the SROC curve

CI:

Confidence interval

CNKI:

China National Knowledge Infrastructure

CNS:

Central nervous system

DOR:

Diagnostic odds ratio

EMBASE:

Biomedical Database

FN:

False-negative

FP:

False-positive

GH:

Growth hormone

GHD:

Growth hormone deficiency

IRMA:

Immunoradiometric assay

ISS:

Idiopathic short stature

IGF-1 :

Insulin-like growth factor-1

IGFBP-3 :

Insulin-like growth factor binding protein-3

NLR:

Negative likelihood ratio

PLR:

Positive likelihood ratio

QUADAS:

Quality assessment of diagnostic accuracy studies

RDOR:

Relative diagnostic odds ratio

RIA:

Radioimmunoassay

r s :

Spearman’s rank correlation coefficient

SEN:

Sensitivity

SPE:

Specificity

SROC:

Summary receiver operating characteristic curve

TN:

True-negative

TP:

True-positive

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Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Medical Statistics, Nantong University, Nantong, Jiangsu, China

    Yi Shen & Jian Zhang

  2. Department of Epidemiology and Medical Statistics, Lanzhou University, Lanzhou, Gansu, China

    Yanhong Zhao

  3. Ruici Hospital, Nantong, Jiangsu, China

    Yu Yan

  4. Department of Epidemiology and Medical Statistics, Nantong University, Nantong, Jiangsu, China

    Yanmei Liu

  5. Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, People’s Republic of China

    Jin Cai

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  1. Yi Shen
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  2. Jian Zhang
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  4. Yu Yan
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Corresponding author

Correspondence to Jin Cai.

Additional information

Communicated by Peter de Winter

Yi Shen and Jian Zhang contributed equally to this work and should be regarded as joint first authors.

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Shen, Y., Zhang, J., Zhao, Y. et al. Diagnostic value of serum IGF-1 and IGFBP-3 in growth hormone deficiency: a systematic review with meta-analysis. Eur J Pediatr 174, 419–427 (2015). https://doi.org/10.1007/s00431-014-2406-3

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  • DOI: https://doi.org/10.1007/s00431-014-2406-3

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