Abstract
Diagnosing growth hormone deficiency in adults is difficult. Provocation tests are most commonly used for the diagnosis with the insulininduced hypoglycemia test nowadays considered as the “gold standard”. The role of IGF-I concentrations in diagnosing growth hormone deficiency in adults is under discussion. In 58 adult patients with proven growth hormone deficiency, the sensitivity and specificity of IGF-I concentrations in relation to growth hormone deficiency were evaluated. Reference values of plasma IGF-I were obtained from 53 healthy volunteers. Using a calculated cut-off concentration of 15 nmol/l we were able to demonstrate that IGF-I concentration is a reliable screening method for growth hormone deficiency. Using this cut-off point in a patient population younger than 40 years of age, sensitivity was 90% and specificity 89%. For patients exceeding the age of 40 years, sensitivity, specificity and positive predictive value were rather low, but the negative predictive value was as high as 90%, indicating that for patients over 40 years IGF-I concentrations above 15 nmol/l exclude growth hormone deficiency. In summary, under the age of 40 years measuring plasma IGF-I provides an useful tool to diagnose growth hormone deficiency, whereas above 40 plasma IGF-I values exceeding 15 nmol/l virtually exclude growth hormone deficiency.
Similar content being viewed by others
References
Hoffman D.M., Ho K.K.Y. The diagnosis of growth hormone deficiency in adults. In: Juul A., Jørgenson J.O.L. (Eds.), Growth hormone in adults. Cambridge University Press, Cambridge, 1996, p. 168.
Rosenfeld R.G., Albertsson-Wikland K., Cassorla F., Frasier S.D., Hasegawa Y., Hintz R.L., Lafranchi S., Lippe B., Loriaux L., Melmed S. Diagnostic controversion: The diagnosis of childhood growth hormone deficiency revisited. J. Clin. Endocrinol. Metab. 1995, 80: 1532–1540.
Cianfarani S., Boemi S., Spagnoli A., Cappa M., Argiro G., Vaccaro F., Manca-Bitti M.L., Boscherini B. Is IGF binding protein-3 assessment helpful lor the diagnosis of GH deficiency? Clin. Endocrinol. (Oxf.) 1995, 43: 43–47.
Ghigo E., Aimaretti G., Gianotti L., Bellone J., Arvat E., Camanni F. New approach to the diagnosis of growth hormone deficiency in adults. Eur. J. Endocrinol. 1996, 134: 352–356.
Boer de H., Blok G.J., Popp-Snijders C., van der Veen E.A. Diagnosis of growth hormone deficiency in adults. Lancet 1994, 343: 1645–1646.
Juul A., Kastrup K., Pedersen S.A., Skakkebæk N.E. Growth hormone (GH) provocation retesting of 108 young adults with childhood-onset GH deficiency and the diagnostic value of insulin-like growth factor I (IGF-I) and IGF binding protein-3. J. Clin. Endocrinol. Metab. 1997, 82: 1195–1201.
Hoffman D.M., O’Sullivan A.J., Baxter R., Ho K.K. Diagnosis of growth-hormone deficiency in adults. Lancet 1994, 343: 1064.
Bates A.S., Evans A.J., Jones P., Clayton R.N. Assessment of GH status in adults with GH deficiency using serum growth hormone, serum insulin like growth factor I and urinary growth hormone secretion. Clin. Endocrinol. (Oxf.) 1995, 42: 425–430.
Baum H.B., Biller B.M., Katznelson L., Oppenheim D.S., Clemmons D.R., Cannistraro K.B., Schoenfeld D.A., Best S.A., Klibanski A. Assessment of growth hormone (GH) secretion in men with adult onset GH deficiency compared with that in normal men — A clinical research centre study. J. Clin. Endorinol. Metab. 1996, 81: 84–92.
Jørgensen J.O., Pedersen S.A., Thuesen L., Jørgensen J., Ingemann-Hansen T., Skakkebæk N., Christiansen J.S. Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet i: 1989, 1221–1225.
Ingelfinger J.A., Mosteller F., Thiodeau L.A., Ware J.H. Biostatistics in clinical medicine, ed. 4., p.124–132. Collier MacMillan Publ., London, 1987.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Span, J.P.T., Pieters, G.F.F.M., Sweep, C.G.J. et al. Plasma IGF-I is a useful marker of growth hormone deficiency in adults. J Endocrinol Invest 22, 446–450 (1999). https://doi.org/10.1007/BF03343588
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03343588